Individual
JEREMY M AINSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., ATC
Contact information
Practice address
221 MAIN ST E, MONMOUTH, OR 97361-2240
(503) 838-4244
(503) 838-4442
Mailing address
12698 KINGS VALLEY HWY, MONMOUTH, OR 97361-9551
(503) 606-2077
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1000092
OR
Other
Enumeration date
10/05/2005
Last updated
07/08/2007
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