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Individual

JEANETTA FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LAT, ATC

Contact information

Practice address
1 UNIVERSITY DR, UPO 823, CAMPBELLSVILLE, KY 42718-2190
(270) 789-5333
Mailing address
1 UNIVERSITY DR, UPO 823, CAMPBELLSVILLE, KY 42718-2190
(270) 789-5333

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT903
KY

Other

Enumeration date
02/14/2012
Last updated
02/14/2012
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