Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEFFERSON JACKSON WETHERINGTON, MS, LAT, ATC
Active Sole ProprietorJEFFERSON JACKSON WETHERINGTON, MS, LAT, ATC is a Athletic Trainer healthcare provider located in BOISE, Idaho. NPI 1992030803 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · BOISE, ID
Registration Details
- NPI Number
- 1992030803
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 9, 2009 (16.804472872927 yrs)
- Last Updated
- Mar 19, 2020
- Licenses
-
2601001331 (MI)AL 2738 (FL)10160747 (OR)#13-0839 (ID)AT468 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
600 N ROBBINS RD STE 200BOISE, ID, 837024565Browse ID providers · Browse ZIP 83702
- Phone
- 6164479996
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Athletic Trainer
- Additional Specialty
- Athletic Trainer
- Additional Specialty
- Specialist/Technologist, Surgical
- Additional Specialty
- Athletic Trainer
Other Athletic Trainer Providers in BOISE, ID
| Name | Credential | NPI |
|---|---|---|
| DR. DAVE LYNN HAMMONS I | ATC | 1285607598 |
| MR. ERIC ANTHONY TAYLOR | ATC | 1013979046 |
| ASHLEE NOEL HARLOW | ATC | 1619912458 |
| JAMES FLOYD SPOONER | ATC | 1033154802 |
| JESSE GEORGE COPS | ATC, LAT | 1770528333 |
| MS. NICOLE LORRAINE CLARK | LAT, ATC | 1538196563 |
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.