Individual
MRS. JACQUELINE ANNE LUPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
824 STILLWOOD DR, SAVANNAH, GA 31419-2643
(912) 961-8764
Mailing address
824 STILLWOOD DR, SAVANNAH, GA 31419-2643
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
AT004124
GA
2255A2300X
Athletic Trainer
2000028113
CO
Other
Enumeration date
06/08/2017
Last updated
08/13/2023
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