Individual
MR. CODY JAMES JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, ATC, LAT
Contact information
Practice address
15 MOUNT PELIA RD, MARTIN, TN 38237-3313
(731) 881-7679
Mailing address
525 MOUNT PELIA RD APT 19, MARTIN, TN 38237-3399
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000002259
TN
Other
Enumeration date
04/08/2020
Last updated
04/08/2020
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