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1629142823
JERRY DANIEL WHEAT
FORT WORTH, TX
NPI
1629142823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX 0329)
Enumeration Date
2006-11-20
Last Update Date
2007-07-08
Business Address
-- JERRY DANIEL WHEAT ATC, LAT
3700 W BERRY LUPTON STADIUM
FORT WORTH, TX 76129-0001
Phone number: 817-257-5156
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Mailing Address
-- JERRY DANIEL WHEAT ATC, LAT
2109 LINCOLN CT
FLOWER MOUND, TX 75028-8363
Phone number: 972-691-2625
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