Individual
JACK JEROME BARRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PERSONAL TRAINER
Contact information
Practice address
2511 LANTRAC CT, DECATUR, GA 30035-4006
(770) 593-8033
(770) 593-3248
Mailing address
2511 LANTRAC CT, DECATUR, GA 30035-4006
(770) 593-8033
(770) 593-3248
Taxonomy
Speciality
Code
Description
License number
State
103TE1100X
Exercise & Sports Psychologist
—
—
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
174H00000X
Health Educator
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
246Z00000X
Other Specialist/Technologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/25/2010
Last updated
07/18/2011
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