Individual
JAYLYNN BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
17555 IDA WEST RD, PETERSBURG, MI 49270-9564
(734) 279-1012
Mailing address
17555 IDA WEST RD, PETERSBURG, MI 49270-9564
(734) 279-1012
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002603
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/17/2018
Last updated
07/25/2021
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