Individual
DEONDRAY D JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
337 CAPITOL ST, NEW MADRID, MO 63869-1803
(573) 521-9184
Mailing address
337 CAPITOL ST, NEW MADRID, MO 63869-1803
(573) 521-9184
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MO
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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