Heather Nicole Jacques

NPI #1053825810 in Fife Lake, Michigan

Provider Information

NPI Number: 1053825810
Entity Type: Individual
Name: Heather Nicole Jacques
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Nov 30, 2017
Last Updated: Nov 30, 2017

Practice Location

Address: 10560 HAGER RD
City: Fife Lake
State: Michigan
ZIP Code: 49633-9312
Phone: (231) 735-3067

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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