Individual
MAGGIE ALEXANDRA WOLODKEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6100 N HAMILTON RD, WESTERVILLE, OH 43081-2062
(614) 366-4332
Mailing address
1 MIRADA DR N UNIT 423, LEWIS CENTER, OH 43035-7707
(614) 814-8054
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT006364
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000041855
BOC NUMBER FOR ATHLETIC TRAINERS
—
01
—
AT006364
OHIO STATE ATHLETIC TRAINING LICENSE
OH
Enumeration date
12/08/2021
Last updated
12/08/2021
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