Individual
JENNA WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, L.A.T.
Contact information
Practice address
1701 HAMILTON ST, DOUGLAS, WY 82633-2781
(307) 340-0631
Mailing address
36 LAKEVIEW DR, DOUGLAS, WY 82633-9001
(307) 340-0631
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
009
WY
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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