Individual
JERRY DANIEL WHEAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3700 W BERRY, LUPTON STADIUM, FORT WORTH, TX 76129-0001
(817) 257-5156
Mailing address
2109 LINCOLN CT, FLOWER MOUND, TX 75028-8363
(972) 691-2625
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0329
TX
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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