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Individual

MRS. JEANNIE WAKELYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS ATC LT

Contact information

Practice address
3 ISLAND CT, POQUOSON, VA 23662-1638
(757) 880-9165
Mailing address
PO BOX 2129, POQUOSON, VA 23662-0129
(757) 880-9165

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001151
VA

Other

Enumeration date
04/17/2016
Last updated
04/17/2016
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