Individual
MISS JAMIE LYNNE LAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, PES, EMT
Contact information
Practice address
413 MARKET ST APT 1, BROWNSVILLE, PA 15417-1774
(814) 244-9049
Mailing address
1841 EUGENE ST, JOHNSTOWN, PA 15904-1009
(814) 254-4726
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004098
PA
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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