Individual
MR. JACK W ONEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, AT, CES
Contact information
Practice address
6955 HOSPITAL DR, DUBLIN, OH 43016-8580
(614) 619-9920
Mailing address
4117 SEQUOIA AVE, GROVE CITY, OH 43123-9031
(614) 619-9920
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004644
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT004644
OT, PT, AT BOARD
OH
Enumeration date
12/02/2020
Last updated
12/02/2020
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