Individual
JESSICA HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420
Mailing address
1 ASHLEY PARK PL, APT 406E, THOMASVILLE, GA 31792-6391
(803) 261-4537
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002504
GA
Other
Enumeration date
10/02/2015
Last updated
09/20/2016
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