Individual
MRS. JENNIFER RENEE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LMT
Contact information
Practice address
209 E PENNSYLVANIA AVE, JACKSONVILLE, IL 62650-3435
(217) 243-3926
Mailing address
209 E PENNSYLVANIA AVE, JACKSONVILLE, IL 62650-3435
(217) 243-3926
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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