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1902860141
JENNA LYNN DECRAENE
FORT WAYNE, IN
NPI
1902860141
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001248A)
Enumeration Date
2006-04-14
Last Update Date
2022-08-27
Business Address
Mrs. JENNA LYNN DECRAENE A.T.C., LAT
7920 W JEFFERSON BLVD SUITE 100
FORT WAYNE, IN 46804-4168
Phone number: 260-459-0917
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Mailing Address
Mrs. JENNA LYNN DECRAENE A.T.C., LAT
952 SKILLET AVE
HUNTERTOWN, IN 46748-0109
Phone number: 260-515-0065
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