Individual
JAMES KENNETH JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
200 ATHLETIC CENTER GALLAGHER IBA ARENA, STILLWATER, OK 74078-0001
(910) 538-7980
Mailing address
315 S HESTER ST APT 319, STILLWATER, OK 74074-3415
(910) 538-7980
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1048
OK
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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