Individual
JUSTIN KEITH WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
900 SISK AVENUE EXTENDED STE C, OXFORD, MS 38655-3433
(662) 449-9190
Mailing address
702 HAPPY LN, OXFORD, MS 38655-9634
(662) 820-0801
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-0708
MS
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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