Individual
JACKSON WHALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 SW 35TH PL APT C307, GAINESVILLE, FL 32608-9378
(386) 405-8395
Mailing address
3000 SW 35TH PL APT C307, GAINESVILLE, FL 32608-9378
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/16/2016
Last updated
12/16/2016
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