Jessica Marie Theroux in Appleton - Athletic Trainer
Jessica Marie Theroux - NPI 1770631350
Jessica Marie Theroux is a Athletic Trainer in Appleton, Wisconsin. Jessica Marie Theroux practices all healthcare services and medical treatments related to Athletic Trainer. The NPI Number for Jessica Marie Theroux is 1770631350. The last update date is 2007-07-08.
Jessica Marie Theroux's current location address is 2105 E Enterprise Ave, Appleton, Wisconsin. You can contact this provider via phone number 9209912561 and fax number 9209912563. The mailing address for Jessica Marie Theroux is 2105 E Enterprise Ave, Appleton, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jessica Marie Theroux |
|---|---|
| Address | 2105 E Enterprise Ave, Appleton, Wisconsin |
| Phone Number | 9209912561 |
| Fax Number | 9209912563 |
| Sole Proprietor | N |
| Credentials | ATC, CSCS |
NPI Number Detail
| NPI Number | 1770631350 |
|---|---|
| Provider Enumeration Date | 2007-01-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2105 E Enterprise Ave |
|---|---|
| City | Appleton |
| State | Wisconsin (WI) |
| Post Code | 549137862 |
| Phone Number | 9209912561 |
| Fax Number | 9209912563 |
Provider's Primary Taxonomy Detail
| Speciality | Athletic Trainer |
|---|---|
| Taxonomy | 2255A2300X |
| Licence No | 465-039 |
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Definition: Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-leve |
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What is the unique identifier code issued to Jessica Marie Theroux by the Centers for Medicare & Medicaid Services?
The Jessica Marie Theroux has been assigned the NPI (National Provider Identifier) 1770631350. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jessica Marie Theroux?
The Jessica Marie Theroux is situated at 2105 E Enterprise Ave, in the city of Appleton, state of WI, with the zip code 549137862.
What is Jessica Marie Theroux's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jessica Marie Theroux's area of specialization is Athletic Trainer, and the corresponding taxonomy code that categorizes this field of practice is 2255A2300X.
On what date was the 1770631350 assigned to Jessica Marie Theroux?
The Jessica Marie Theroux was issued its 1770631350 on 2007-01-08, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Jessica Marie Theroux most recently updated or refreshed?
The details pertaining to the Jessica Marie Theroux, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.