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Individual

MRS. LAURA LEA JONES-WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
2382 NW GRENFELL LOOP, MCMINNVILLE, OR 97128-6655
(503) 857-0167
Mailing address
2382 NW GRENFELL LOOP, MCMINNVILLE, OR 97128-6655
(503) 857-0167

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2255A2300X
ATHLETIC TRAINER
WA
Enumeration date
06/02/2006
Last updated
09/13/2007
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