Individual
JILLIAN ELISSA CORREALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 COUNTRY CLUB LN, SUGARLOAF, PA 18249-3716
(570) 751-9311
Mailing address
PO BOX 1299, CONYNGHAM, PA 18219-1299
(570) 751-9311
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007983
PA
Other
Enumeration date
05/12/2022
Last updated
06/07/2022
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