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1992991947
JESSE P AMBURN
TYLER, TX
NPI
1992991947
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT2013)
Enumeration Date
2007-09-23
Last Update Date
2007-09-23
Business Address
Mr. JESSE P AMBURN LAT,ATC
3414 GOLDEN RD
TYLER, TX 75701-8336
Phone number: 903-939-7500
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Mailing Address
Mr. JESSE P AMBURN LAT,ATC
3414 GOLDEN RD
TYLER, TX 75701-8336
Phone number: 903-939-7500
Copy
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