Individual
PROF. JERRY VANCE PICKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD, ATC, LAT
Contact information
Practice address
4925 BOONSBORO RD # 190, LYNCHBURG, VA 24503-2240
(434) 592-3762
Mailing address
4925 BOONSBORO RD # 190, LYNCHBURG, VA 24503-2240
(434) 592-3762
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000726
VA
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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