Individual
JENA LYNN HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4271 LEIDY AVE, PHILADELPHIA, PA 19104-1016
(215) 840-1232
Mailing address
4271 LEIDY AVE, PHILADELPHIA, PA 19104-1016
(215) 840-1232
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003143
PA
Other
Enumeration date
05/04/2006
Last updated
09/26/2008
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