Individual
JESSICA CARACCIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4122 SHARK CT APT A, GREAT LAKES, IL 60088-1142
(805) 750-3323
Mailing address
4122 SHARK CT APT A, GREAT LAKES, IL 60088-1142
(805) 750-3323
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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