Individual
EDWARD JONATHAN BREIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., ATC
Contact information
Practice address
1325 EAST FORTICATION STREET, JACKSON, MS 39202
(661) 466-3262
Mailing address
520 VINE DR APT 8C, FLOWOOD, MS 39232-7744
(661) 466-3262
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000009324
TN
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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