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1972076305
JIMMY LEE FAIRFAX
MIAMI, FL
NPI
1972076305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL al2413)
Enumeration Date
2019-01-08
Last Update Date
2019-01-08
Business Address
JIMMY LEE FAIRFAX ATC LAT
14315 SW 106TH CT
MIAMI, FL 33176-7032
Phone number: 484-529-8037
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Mailing Address
JIMMY LEE FAIRFAX ATC LAT
14315 SW 106TH CT
MIAMI, FL 33176-7032
Phone number: 484-529-8037
Copy
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