Individual
MISS DEBORAH JENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
2501 W BELTLINE HWY, SUITE 601, MADISON, WI 53713-2318
(608) 288-6432
Mailing address
430 ORCHARD DR, OREGON, WI 53575-1226
(608) 692-7912
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
405-39
WI
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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