Individual
MR. GREGORY LEE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
3821 EVERETTS DL, LEXINGTON, KY 40514-1185
(859) 351-6789
Mailing address
3821 EVERETTS DL, LEXINGTON, KY 40514-1185
(859) 351-6789
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
KY
Other
Enumeration date
04/20/2006
Last updated
07/08/2007
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