Individual
JENNIFER ROSE ESTVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1300 S COLUMBIA RD, GRAND FORKS, ND 58201-4012
(701) 780-4988
Mailing address
PO BOX 373, LARIMORE, ND 58251-0373
(701) 388-7633
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2142
MN
2255A2300X
Athletic Trainer
Primary
315-06
ND
Other
Enumeration date
01/02/2007
Last updated
03/10/2014
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