Individual
JESSICA NODAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
4202 E FOWLER AVE STOP ATH100, TAMPA, FL 33620-8455
(702) 403-9658
Mailing address
13560 CYPRESS GLEN LN UNIT 202, TAMPA, FL 33637-1116
(702) 403-9658
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL5698
FL
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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