Individual
MS. JILL NICOLE LEUTHOLD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, L
Contact information
Practice address
2640 W MARKET ST, SUITE 202, FAIRLAWN, OH 44333-4202
(330) 869-2635
(330) 869-8315
Mailing address
7575 ELYRIA RD, MEDINA, OH 44256-8963
(330) 321-9607
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2389
OH
Other
Enumeration date
04/06/2006
Last updated
07/08/2007
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