Individual
HEATHER NICOLE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10560 HAGER RD, FIFE LAKE, MI 49633-9312
(231) 735-3067
Mailing address
10560 HAGER RD, FIFE LAKE, MI 49633-9312
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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