Individual provider · NPI-1

Jennifer Farroll, Ed.D., LAT, ATC

Specialist/Technologist, Athletic Trainer · Jackson, TN

NPI number1790229060

StatusActive

Last updated in NPPESDec 6, 2016

Details

NPI: 1790229060
Entity type: Individual (NPI-1)
Name: Ms. Jennifer Farroll
Credential: Ed.D., LAT, ATC
Sex: Female
Sole proprietor: No
Enumeration date: Dec 6, 2016
Last updated: Dec 6, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2255A2300X	Specialist/Technologist, Athletic Trainer	0000001419	TN	Yes

Practice location

1050 Union University Dr
Box 1864
Jackson, TN 38305-3656

Phone 731-661-5024

Mailing address

124 Enfield Cv
Medina, TN 38355-6932

Phone 731-661-5024

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