NPI 1487496402

Jewelle Ruth Jacklen, ATC

Practitioner Athletic Trainer Coon Rapids, MN

Practice location

Address: 11860 Zea St NW APT 306, Coon Rapids, MN 55433-6838
Phone: (763) 218-5332

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 3542 (MN)

Other Specialist/Technologist providers in Minnesota →

Registry record

NPI: 1487496402
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Jun 2024
Record last updated: 10 Jun 2024

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.