Individual
MR. WILLIAM VAN HARDIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 397-0795
(601) 960-4586
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 397-0795
(601) 960-4586
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0344
MS
Other
Enumeration date
02/08/2010
Last updated
02/08/2010
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