NPI 1083052898

Jennifer L Ladner, ATC

Practitioner Athletic Trainer Long Beach, MS

Practice location

Address: 5132 Beatline Rd Suite D, Long Beach, MS 39560-3869
Phone: (228) 669-0792
Fax: (228) 575-8891
Mailing address: 231 Lantana Blvd, Long Beach, MS 39560-5631

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT0477 (MS)

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Registry record

NPI: 1083052898
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jun 2013
Record last updated: 13 Jun 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.