Individual
MR. JUSTIN HEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1500 PEACHTREE ST, JACKSON, MS 39202-1754
(601) 968-8791
Mailing address
1500 PEACHTREE ST, JACKSON, MS 39202-1754
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0670
MS
Other
Enumeration date
01/01/2015
Last updated
01/01/2015
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