Individual
MS. JESSICA ELIZABETH DAUTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2350 BROADHOLLOW RD, FARMINGDALE, NY 11735-1006
(631) 794-6281
(631) 794-6289
Mailing address
2350 BROADHOLLOW RD, FARMINGDALE, NY 11735-1006
(631) 794-6281
(631) 794-6289
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002312-1
NY
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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