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1568855724
LARRY JACKSON
LEXINGTON, KY
NPI
1568855724
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2015-03-12
Last Update Date
2015-03-15
Business Address
Mr. LARRY JACKSON
826 WARFIELD PL
LEXINGTON, KY 40505-3612
Phone number: 859-421-2250
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Mailing Address
Mr. LARRY JACKSON
826 WARFIELD PL
LEXINGTON, KY 40505-3612
Phone number: 859-421-2250
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