Individual
MS. JESSE MILLER PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
500 E 9TH ST, CLAREMONT, CA 91711-6400
(909) 607-9958
Mailing address
500 E 9TH ST, CLAREMONT, CA 91711-6400
(909) 607-9958
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000014477
BOC CERTIFIED ATHLETIC TRAINER
—
Enumeration date
08/05/2019
Last updated
08/05/2019
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