Individual
MRS. JILLIAN LEE WITHINGTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS,ATC,CSCS
Contact information
Practice address
8 ABBOTT PARK PL, PROVIDENCE, RI 02903-3703
(401) 598-1631
Mailing address
98 MAJESTIC AVE, WARWICK, RI 02888-2359
(401) 781-4273
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT00165
RI
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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