Individual
JAMIE E PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
823 28TH ST, ROCKFORD, IL 61108-3651
(815) 994-6143
Mailing address
823 28TH ST, ROCKFORD, IL 61108-3651
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096002366
IL
2255A2300X
Athletic Trainer
3159-39
WI
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
09/29/2023
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