Individual
JEREMY KULBETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 540-2972
Mailing address
39297 CRAWFORD RD, FRANKLINTON, LA 70438-2907
(318) 470-8887
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0729
MS
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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