Individual
BEAU JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/LAT
Contact information
Practice address
300 NORTHWEST PLZ, 164, SENATOBIA, MS 38668-1746
(662) 812-1168
Mailing address
2714 W OXFORD LOOP, 164, OXFORD, MS 38655-5711
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0535
MS
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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