Individual
VANESSA JACQUELINE JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT, CES
Contact information
Practice address
309 S MEDFORD DR, LUFKIN, TX 75901-5245
(936) 632-7656
Mailing address
4106 COLLEGE DR APT 1014, LUFKIN, TX 75901-7383
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6024
TX
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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