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1255712048
EDWARD JONATHAN BREIGHT
JACKSON, MS
NPI
1255712048
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TN 2000009324)
Enumeration Date
2015-06-17
Last Update Date
2015-06-17
Business Address
-- EDWARD JONATHAN BREIGHT M.S., ATC
1325 EAST FORTICATION STREET
JACKSON, MS 39202
Phone number: 661-466-3262
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Mailing Address
-- EDWARD JONATHAN BREIGHT M.S., ATC
520 VINE DR APT 8C
FLOWOOD, MS 39232-7744
Phone number: 661-466-3262
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