Individual
JESSICA L KUSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1812 MARSH RD, STORE 505, WILMINGTON, DE 19810-4581
(302) 475-7500
(302) 475-5787
Mailing address
7206 PLEASANT CT, WILMINGTON, DE 19802-1771
(302) 762-1361
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
J3-0000167
DE
Other
Enumeration date
02/14/2007
Last updated
07/08/2007
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