Individual
MADISON FILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5284 PREAKNESS CT, COLUMBUS, OH 43221-5604
(614) 506-4760
Mailing address
5284 PREAKNESS CT, COLUMBUS, OH 43221-5604
(614) 506-4760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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