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Individual

ASHLEY JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
5929 MILL CREEK DR APT 809, HAZELWOOD, MO 63042-3932
(316) 880-5688
Mailing address
5929 MILL CREEK DR APT 809, HAZELWOOD, MO 63042-3932
(316) 880-5688

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2017025988
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2017025988
MISSOURI STATE LICENSED ATHLETIC TRAINER
MO
Enumeration date
10/18/2016
Last updated
09/26/2022
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