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Individual

MISS LOUANNE MARIE JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
MICHIGAN STATE UNIVERSITY DEPT OF ATHLETICS, #131 DUFFY DAUGHERTY FB BLDG, EAST LANSING, MI 48824-1214
(517) 353-4369
(517) 432-2137
Mailing address
4000 NORFOLK CT, LANSING, MI 48910-0619
(517) 353-4369
(517) 432-2137

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MI

Other

Enumeration date
02/16/2007
Last updated
07/08/2007
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