Individual
DEBORAH JALLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1370 N SHAWANO ST, NEW LONDON, WI 54961-7944
(920) 982-0100
Mailing address
1017 OSHKOSH ST, NEW LONDON, WI 54961-1635
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1129-039
WI
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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