Individual
JACOB ANTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 LINCOLN AVE, LAKEWOOD, OH 44107-6059
(216) 235-6404
Mailing address
2220 LINCOLN AVE, LAKEWOOD, OH 44107-6059
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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