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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKSON RANDALL THERRIEN

Active

Athletic Trainer · DECATUR, MS

Registration Details

NPI Number
1871079442
Provider Type
Individual
Gender
Male
NPI Issued
Jul 17, 2018 (7.7970822463769 yrs)
Last Updated
Jul 17, 2018
License
AT0792 (MS)

Practice Information

Address
224 CROWS NEST CIR
DECATUR, MS, 393279186
Browse MS providers · Browse ZIP 39327
Phone
6016786199
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in DECATUR, MS

Name Credential NPI
DERRICK WESLEY JONES ATC 1750867776
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.