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General NPI Number Information
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NPI Number | 1043777113
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Entity Type | Individual
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Provider Name | JOSLYNN TRAIL MS, AT
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Gender | Female
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 19701 OH-339
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City | WATERFORD
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State | OH
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Zip | 45786
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Country | US
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Telephone | 740-984-2342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | WATERFORD
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State | OH
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Zip | 45786-0067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 004228
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License Number State | OH
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