Individual
JESSICA LANE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
17 CYPRESS CREEK FARM RD, SANFORD, NC 27332
(919) 353-4580
Mailing address
17 CYPRESS CREEK FARM RD, SANFORD, NC 27332-2186
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/21/2017
Last updated
06/21/2017
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