Individual
MS. ELISSA JAIME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
150 INDUSTRIAL BLVD, TOANO, VA 23168-9215
(757) 291-0935
Mailing address
PO BOX 184, BARHAMSVILLE, VA 23011-0184
(757) 291-0935
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002268
VA
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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