Individual
JACOB HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
200 CAPITOL ST, CLINTON, MS 39056-4026
(769) 798-7138
Mailing address
203 LAWSON ST, CLINTON, MS 39056-4249
(225) 240-9220
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0865
MS
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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