Individual
JESSICA LYDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2901 SANTA MARIA DR, GILBERTSVILLE, PA 19525-9321
(484) 374-0580
Mailing address
2901 SANTA MARIA DR, GILBERTSVILLE, PA 19525-9321
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003609
PA
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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