Individual
JASON WIMBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
205 WHETSELL ST, REEVESVILLE, SC 29471-4924
(843) 563-8133
Mailing address
205 WHETSELL ST, REEVESVILLE, SC 29471-4924
(843) 563-8133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
636
SC
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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