Individual
JANA PAIGE WHIDDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2215 US HIGHWAY 341 S, PERRY, GA 31069-9582
(478) 319-4012
Mailing address
2215 US HIGHWAY 341 S, PERRY, GA 31069-9582
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003458
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/03/2018
Last updated
03/09/2021
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