Individual
MRS. JENNIFER LYNN CLOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5260 WILLIAMS LAKE RD, WATERFORD, MI 48329-3556
(248) 857-3272
(248) 857-3272
Mailing address
19303 BALDWIN CIR, HOLLY, MI 48442-9528
(248) 846-4337
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001801
OH
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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