Individual
JILLIAN BRENNA PERRAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5823 WIDEWATERS PKWY, EAST SYRACUSE, NY 13057-3084
(607) 483-3782
Mailing address
16 ABBEY RD, ELMIRA, NY 14905-1735
(607) 483-3782
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
07/18/2023
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