Individual
MR. WINSTON PAUL LIGHTBODY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LAT, ATC
Contact information
Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 996-2787
Mailing address
3716 N 55TH ST, TAMPA, FL 33619-1426
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2601001752
MI
2255A2300X
Athletic Trainer
4615
FL
2255A2300X
Athletic Trainer
Primary
AT9924
TX
Other
Enumeration date
06/27/2017
Last updated
01/06/2025
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