Individual
JENNIFER OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
2 JOBS GATE 1, PORTLAND, CT 06480-1750
(860) 919-1113
Mailing address
2 JOBS GATE 1, PORTLAND, CT 06480-1750
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1500
CT
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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