Individual
JENNIFER ELIZABETH NEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
200 JOHN BALLENTINE RD, IRMO, SC 29063-9352
(803) 781-6448
Mailing address
200 JOHN BALLENTINE RD, IRMO, SC 29063-9352
(803) 781-6448
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
704
SC
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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