Individual
BRYCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
101 UNIVERSITY DR, RADFORD, VA 24141
(540) 831-5345
Mailing address
487 WOODLAND AVE, WOOSTER, OH 44691-2769
(330) 317-8426
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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