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1033610415
DERRICK JACKSON THOMAS
SAVANNAH, GA
NPI
1033610415
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA AT003116)
Enumeration Date
2018-02-22
Last Update Date
2018-02-22
Business Address
DERRICK JACKSON THOMAS ATC
1 BONNYBRIDGE RD
SAVANNAH, GA 31407-1312
Phone number: 704-796-9595
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Mailing Address
DERRICK JACKSON THOMAS ATC
1 BONNYBRIDGE RD
PORT WENTWORTH, GA 31407-1312
Phone number: 704-796-9595
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