Individual
MRS. JENNIFER LYNN STASKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 COPPERFIELD LN, CHARLESTON, IL 61920-3600
(217) 246-6429
Mailing address
1 COPPERFIELD LN, CHARLESTON, IL 61920-3600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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