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Individual

JESSICA JEAN HAVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
10040 BAKER RD, GREENVILLE, MI 48838-9486
(269) 838-5089
Mailing address
10040 BAKER RD, GREENVILLE, MI 48838-9486
(269) 838-5089

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000643
MI

Other

Enumeration date
06/16/2012
Last updated
06/16/2012
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