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Individual

MR. JAY CHENOWETH THOMPSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MED, ATC, LAT

Contact information

Practice address
1401 W MEADOWS AVE, LEESBURG, FL 34748-5643
(352) 787-5047
Mailing address
2028 MEADOWSIDE DR, EUSTIS, FL 32726-2331
(407) 739-8047

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1766
FL

Other

Enumeration date
04/26/2006
Last updated
04/28/2008
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