Individual
MISS JESSICA ESTELLE BUGTONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 BRADDOCK RD, FROSTBURG, MD 21532-2303
(301) 806-2445
Mailing address
1110 HULL DR, EDGEWATER, MD 21037-4131
(301) 806-2445
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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