Individual
JESSICA LYNN WHALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(614) 403-3572
Mailing address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001650A
IN
Other
Enumeration date
12/15/2011
Last updated
11/03/2014
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