Individual
T. JAMIE SCHUPBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 DELAWARE AVE, ELYRIA, OH 44035-6669
(440) 309-6773
Mailing address
850 DELAWARE AVE, ELYRIA, OH 44035-6669
(440) 309-6773
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
954
OH
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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