Individual
MR. JASON AVERY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
211 LANCASTER DR, ANDERSON, SC 29621-1969
(864) 314-5815
Mailing address
211 LANCASTER DR, ANDERSON, SC 29621-1969
(864) 314-5815
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
325
SC
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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