Individual
MISS JADA RAE CONNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
5615 DEAUVILLE STE 220, MIDLAND, TX 79706-2707
(432) 221-4004
Mailing address
5510 RIO GRANDE AVE, MIDLAND, TX 79707-9701
(318) 564-0376
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4325
TX
Other
Enumeration date
04/13/2010
Last updated
05/08/2022
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