Individual
JESSIE FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
229 HOPE STREET, PROVIDENCE, RI 02912-7001
(401) 369-4406
Mailing address
229 HOPE STREET BOX 1932, PROVIDENCE, RI 02912-7001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/04/2017
Last updated
10/26/2022
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