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1114427416
JENNIFER LEE EDA
VIRGINIA BEACH, VA
NPI
1114427416
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126002865)
Enumeration Date
2018-02-14
Last Update Date
2018-02-14
Business Address
JENNIFER LEE EDA ATC
4740 BOXFORD RD
VIRGINIA BEACH, VA 23456-5007
Phone number: 757-353-2419
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Mailing Address
JENNIFER LEE EDA ATC
4740 BOXFORD RD
VIRGINIA BEACH, VA 23456-5007
Phone number: 175-743-5324
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