NPI 1255712048

Edward Jonathan Breight, MSATC

Practitioner Athletic Trainer Jackson, MS

Practice location

Address: 1325 East Fortication Street, Jackson, MS 39202
Phone: (661) 466-3262
Mailing address: 520 Vine Dr APT 8c, Flowood, MS 39232-7744

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2000009324 (TN)

Other Specialist/Technologist providers in Mississippi →

Registry record

NPI: 1255712048
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jun 2015
Record last updated: 17 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.