Individual
JAILENE ERICKA OLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
163 STORMONT ST, NEW CONCORD, OH 43762-1118
(740) 826-8211
Mailing address
1319 MAYFIELD RIDGE RD, MAYFIELD HTS, OH 44124-1538
(216) 479-9608
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT005931
OH
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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