Individual
JASMINE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 MELINDA DR APT 15, LYNCHBURG, VA 24502-3249
(434) 515-3287
Mailing address
101 MELINDA DR APT 15, LYNCHBURG, VA 24502-3249
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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