Individual
MISS JESSICA J MCNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPA, AT, ATC
Contact information
Practice address
5101 JOHN C LODGE FWY, DETROIT, MI 48202-3327
(313) 577-1008
(313) 577-1012
Mailing address
5101 JOHN C LODGE FWY, DETROIT, MI 48202-3327
(313) 577-1008
(313) 577-1012
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001090
MI
Other
Enumeration date
03/27/2018
Last updated
03/27/2018
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