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1053825067
JENNIFER DETLEFSEN
BETHLEHEM, CT
NPI
1053825067
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: CT 764)
Enumeration Date
2017-11-29
Last Update Date
2017-11-29
Business Address
JENNIFER DETLEFSEN ATC, MHA
57 LONG MEADOW RD
BETHLEHEM, CT 06751-1116
Phone number: 203-405-3369
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Mailing Address
JENNIFER DETLEFSEN ATC, MHA
57 LONG MEADOW RD
BETHLEHEM, CT 06751-1116
Phone number: 203-405-3369
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