Individual
JASON KLUCKHOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, SCAT
Contact information
Practice address
200 PATEWOOD DR STE B170, GREENVILLE, SC 29615-6335
(864) 420-7627
Mailing address
225 BALLYHOO CT, GREER, SC 29651-4914
(864) 420-7627
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
384
SC
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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