JEFFERY COWAN BOSARGE

JEFFERSON, LA
NPI1447623889
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS  AT0350)
Enumeration Date2015-11-06
Last Update Date2015-11-06
Business Address
-- JEFFERY COWAN BOSARGE ATC
1221 S CLEARVIEW PKWY
JEFFERSON, LA 70121-1011
Phone number: 228-342-1440
Mailing Address
-- JEFFERY COWAN BOSARGE ATC
684 OAHU ST
DIAMONDHEAD, MS 39525-3540
Phone number: 228-342-1440
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