Individual
MR. DAVID MILLER JESSUP
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1000 S ODELL ST, BROWNSBURG, IN 46112-1929
(317) 852-2258
(317) 852-1495
Mailing address
2 LACY CT, BROWNSBURG, IN 46112-2033
(317) 852-9651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000085A
IN
Other
Enumeration date
03/23/2006
Last updated
07/08/2007
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