Individual
KAREN SYDNI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
125 NATIONWIDE DR, LYNCHBURG, VA 24502-4272
(434) 200-6933
Mailing address
1482 LAKE SHORE DR, FOREST, VA 24551-2131
(434) 414-0632
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000732
VA
Other
Enumeration date
02/21/2007
Last updated
03/31/2017
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