Individual
JEANETTE ELLEN LEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
200 HIGH ST, GLENVILLE, WV 26351-1200
(304) 462-7361
Mailing address
907 WALNUT ST APT A, GLENVILLE, WV 26351-1355
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
088931
IA
Other
Enumeration date
12/06/2019
Last updated
05/22/2024
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