Individual
JARED SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC.,LAT
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-2000
Mailing address
101 KEMPEN LN, MADISON, MS 39110-3401
(601) 613-2437
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0760
MS
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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