Individual
JACK SOUKENIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4707 MILL ST, MANTUA, OH 44255-8934
(330) 274-2747
Mailing address
4707 MILL ST, MANTUA, OH 44255-8934
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.004731
OH
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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