Individual
JILL M MCCORMACK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1209 W 45TH ST, RICHMOND, VA 23225-4626
(804) 231-3553
Mailing address
1209 W 45TH ST, RICHMOND, VA 23225-4626
(804) 231-3553
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000433
VA
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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