Individual
JESSICA ANNE MUNKVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5030 BARICKMAN CT, OSWEGO, IL 60543-6054
(815) 600-4002
Mailing address
5030 BARICKMAN CT, OSWEGO, IL 60543-8009
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004495
IL
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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