Individual
JESSICA LEUPOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA, ATC, LAT
Contact information
Practice address
1100 S NICKEL ST, DEMING, NM 88030-6301
(575) 312-4089
(575) 544-0918
Mailing address
3530 BLUE QUAIL RD SW, DEMING, NM 88030-7727
(575) 312-4089
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
730
NM
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
08/01/2017
Last updated
10/18/2017
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