Individual
JACLYN STUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAT, ATC
Contact information
Practice address
300 PULTENEY ST, BRISTOL GYMNASIUM, GENEVA, NY 14456-3304
(315) 481-5698
Mailing address
300 PULTENEY ST, BRISTOL GYMNASIUM, GENEVA, NY 14456-3304
(315) 481-5698
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003053-1
NY
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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