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1093424970
JELANI BACKUS
BRIDGEWATER, VA
NPI
1093424970
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2022-11-18
Last Update Date
2022-11-18
Business Address
JELANI BACKUS
402 E COLLEGE ST
BRIDGEWATER, VA 22812-1511
Phone number: 540-828-8000
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Mailing Address
JELANI BACKUS
402 E COLLEGE ST
BRIDGEWATER, VA 22812-1511
Phone number: 540-828-8000
Copy
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