Individual
JENNE DEANGELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2195 HARRODSBURG RD, LEXINGTON, KY 40504-3504
(859) 300-1004
Mailing address
2195 HARRODSBURG RD, LEXINGTON, KY 40504-3504
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
AT1157
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912169756
ATHLETIC TRAINING
KY
Enumeration date
08/01/2018
Last updated
08/01/2018
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