Individual
ALICIA JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 562-2571
Mailing address
10641 HIGHWAY 492 E, UNION, MS 39365-9467
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0693
MS
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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