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Individual

JORDAN CARMOSINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1208 HOLLYHILL DR, MIAMISBURG, OH 45342-1937
(513) 283-1629
Mailing address
11598 SCHWAB DR, PARMA, OH 44130-5959
(513) 283-1629

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.004391
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CODE 22
PROVIDER CODE 22 (RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)
OH
Enumeration date
08/25/2014
Last updated
08/24/2018
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