Individual
JACQLYN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
19059 SUNFLOWER PL, RIVERSIDE, CA 92508-6291
(951) 809-3938
Mailing address
19059 SUNFLOWER PL, RIVERSIDE, CA 92508-6291
(951) 809-3938
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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