Individual
JACY CORNELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 PARKSIDE DR, BOONE, IA 50036-5218
(515) 236-1433
Mailing address
1316 PARKSIDE DR, BOONE, IA 50036-5218
(515) 236-1433
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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