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1518459676
BRAXTON DOUGLAS JAMES
JACKSON, MS
NPI
1518459676
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS AT0717)
Enumeration Date
2018-06-05
Last Update Date
2018-06-16
Business Address
BRAXTON DOUGLAS JAMES ATC
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-1000
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Mailing Address
BRAXTON DOUGLAS JAMES ATC
401 WINTERFIELD WAY
BRANDON, MS 39042-6080
Phone number: 601-394-8164
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