Individual
MR. JASPER AYENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
1900 W OLNEY AVE, PHILADELPHIA, PA 19141-1108
(215) 951-1519
Mailing address
2280 BRYN MAWR AVE, PHILADELPHIA, PA 19131-2432
(215) 880-7650
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003394
PA
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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