Individual
MR. JERADE ANDREW PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2026 BAXTERLY AVE, LAKEWOOD, OH 44107-6028
(248) 921-8785
Mailing address
12790 CHAMBERLAIN RD, AURORA, OH 44202-9706
(248) 921-8785
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002960
OH
Other
Enumeration date
05/28/2013
Last updated
10/04/2019
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