Provider Demographics
NPI:1013946805
Name:JURGEL, JAYSON (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JAYSON
Middle Name:
Last Name:JURGEL
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 TILLERY RD APT A-3
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-5520
Mailing Address - Country:US
Mailing Address - Phone:865-680-7967
Mailing Address - Fax:
Practice Address - Street 1:2800 MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-4611
Practice Address - Country:US
Practice Address - Phone:865-680-7967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer