Individual
JESSICA RENEE WESTMAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA,LAT, ATC
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(231) 667-4225
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2019-810-AH-AT-REN
MA
Other
Enumeration date
12/11/2019
Last updated
12/04/2024
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