Individual
JEANNETTE UTTERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
17001 ADDISON RD, ADDISON, TX 75001-5096
(972) 931-8325
Mailing address
2501 SCARLET OAK DR, ROWLETT, TX 75089-1651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6563
TX
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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