Individual
MRS. JENNIFER VON KOLEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S./ A.T.C./L
Contact information
Practice address
5343 W ALAMEDA RD, GLENDALE, AZ 85310-3704
(623) 445-5377
Mailing address
5343 W ALAMEDA RD, GLENDALE, AZ 85310-3704
(623) 587-9368
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0379
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0379
ATHLETIC TRAINER LISC. #
AZ
Enumeration date
04/19/2006
Last updated
07/08/2007
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