Individual
JENNA WING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,LAT,ATC
Contact information
Practice address
1425 S COLUMBIA RD, GRAND FORKS, ND 58201-4039
(701) 746-8374
Mailing address
2151 36TH AVE S APT 103, GRAND FORKS, ND 58201-7171
(224) 226-1448
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/31/2019
Last updated
09/28/2021
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