| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JADA RAE CONNALLY | 1689990822 | 2022-05-08 |
Jada Rae Connally is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1689990822. Registration indicates Jada Rae Connally is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Specialist/Technologist (Specialist/Technologist: Athletic Trainer, ) (All Other Specialties & Provider Types, ) (Specialist/Technologist Athletic Trainer, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Specialist/Technologist, )
| Entity Type | Individual |
| Provider Name | Miss Jada Rae Connally LAT |
| Other Provider Name | Jada Mcbryde |
| Practice Office Address | 5615 DEAUVILLE STE 220 MIDLAND, TX US |
| Practice Office Telephone | 4322214004 |
| Mailing Address | 5510 RIO GRANDE AVE MIDLAND, TX 797079701 US |
| Business Telephone | 3185640376 |
| Code | Practice | License No State |
|---|---|---|
| 2255A2300X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Specialist/Technologist: Athletic Trainer All Other Specialties & Provider Types Specialist/Technologist Athletic Trainer Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist | AT4325
TX |