Individual
KELLY MARIE JAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, ATC
Contact information
Practice address
1501 1ST ST, LANETT, AL 36863-1803
(716) 432-5898
Mailing address
1501 1ST ST, LANETT, AL 36863-1803
(716) 432-5898
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1577
AL
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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