Individual
JEANNA KHARCHILAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
783 BETHEL RD, COLUMBUS, OH 43214
(614) 459-9409
Mailing address
8755 RIVERSIDE DR, POWELL, OH 43065
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1489
LICENSE#
OH
Enumeration date
05/01/2007
Last updated
07/08/2007
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