Individual
JODY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT, CCMA, CES
Contact information
Practice address
1600 ARIZONA AVE, MONROE, LA 71202-3602
(318) 387-2932
Mailing address
139 VICTORY LN, WEST MONROE, LA 71291-1739
(318) 372-2612
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.200402
LA
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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