Individual
JOSHUA WATERSJACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
430406 LAS PULGAS, CAMP PENDLETON, CA 92055
(760) 917-5920
Mailing address
PO BOX 2865, OCEANSIDE, CA 92051-2865
(760) 917-5920
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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