Individual
KAITLYN NICOLE JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6320 ANDERSON ST, SHAWNEE, KS 66226
(913) 240-7194
Mailing address
6320 ANDERSON ST, SHAWNEE, KS 66226
(913) 240-7194
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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