Individual
JEFFERY LEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
540 KINGSLEY AVE, ORANGE PARK, FL 32073-4847
(904) 264-2156
Mailing address
12793 86TH TER, LIVE OAK, FL 32060-8829
(386) 364-1381
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL721
FL
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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