Individual
JESSICA RENEE WALDREP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
10064 STATE HIGHWAY SPUR 264, QUINLAN, TX 75474-8743
(903) 356-1680
Mailing address
419 SECOND ST, CHANDLER, TX 75758-2235
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6339
TX
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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