Individual
ANDREA E JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4754
Mailing address
520 COMMERCIAL ST APT 5, SEYMOUR, WI 54165-8461
(920) 517-1086
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
794-039
WI
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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