Individual
JESSICA DAWN ACHATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
113 RIBBON LN APT M, CARY, NC 27518-6887
(719) 469-9608
Mailing address
113 RIBBON LN APT M, CARY, NC 27518-6887
(719) 469-9608
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1761
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1761
NCBATE
NC
01
—
2000003551
BOC
NC
Enumeration date
06/07/2012
Last updated
06/07/2012
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