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General NPI Number Information
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NPI Number | 1710468921
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Entity Type | Individual
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Provider Name | JADE CHAVALIAR SOWELL-HUNDON ATC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2018
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Last Update Date | 08/25/2018
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Provider Practice Location Address
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Address Line | 2646 PATTERSON RD STE A
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City | GRAND JUNCTION
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State | CO
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Zip | 81506-1941
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Country | US
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Telephone | 970-242-5585
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Fax | 970-242-1740
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Provider Business Mailing Address
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Address Line | 2539 GRAND AVE APT B
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8074
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Country | US
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Telephone | 916-578-0802
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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 |
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License Number State |
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