Lashaunta Jones, AT, ATC

Individual provider Active NPI Athletic Trainer · Wilberforce, OH

NPI 1194147991 · NPPES record last updated Jan 13, 2014

Key facts

NPI
1194147991
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
AT-2478 (OH)
Practice address
1400 Brush Row Rd
Wilberforce, OH 45384-5800
Phone
(937) 376-6617
Fax
(937) 376-6040
NPI assigned
Jan 13, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AT-2478OHMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT-2478 OH Yes

Addresses

Primary practice location

1400 Brush Row Rd
Wilberforce, OH 45384-5800

Mailing address

47 Rockland Dr
Fairborn, OH 45324-4329
Phone (937) 376-6617

Other providers in Wilberforce, OH

All providers in Wilberforce, OH · Athletic Trainer in Ohio

Sources for this page

Verify at the official NPI Registry.