LARRY JACKSON

LEXINGTON, KY
NPI1568855724
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2015-03-12
Last Update Date2015-03-15
Business Address
Mr. LARRY JACKSON
826 WARFIELD PL
LEXINGTON, KY 40505-3612
Phone number: 859-421-2250
Mailing Address
Mr. LARRY JACKSON
826 WARFIELD PL
LEXINGTON, KY 40505-3612
Phone number: 859-421-2250