Individual
JEREMY JINI MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 EAST UNIVERSITY, MAGNOLIA, AR 71754
(901) 262-0851
Mailing address
100 EAST UNIVERSITY 8002, MAGNOLIA, AR 71754
(901) 262-0851
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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