Individual
JENNA KAETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1646 RUSSELL AVE, JEFFERSON CITY, TN 37760-2204
(616) 405-5892
Mailing address
802 EASY CT, HOLLAND, MI 49423-7340
(616) 405-5892
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9706828
TN
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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