# JACK JEROME BARRON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1629378674
- **Gender:** Man
- **Credential:** PERSONAL TRAINER

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TE1100X | Exercise & Sports Psychologist | — | NULL | — |
| 133N00000X | Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 174H00000X | Health Educator | — | NULL | Yes |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2255A2300X | Athletic Trainer | — | NULL | — |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | NULL | — |
| 246Z00000X | Other Specialist/Technologist | — | NULL | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 10/25/2010
- **Last updated:** 07/18/2011