Individual
JERRY SLAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 W CHAMPLAIN AVE, WILMINGTON, DE 19804-2014
(757) 912-4586
Mailing address
412 W. CHAMPLAIN AVE., WILMINGTON, DE 19804
(757) 912-4586
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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