Organization
NATIONWIDE CHILDREN'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KLUCHUROSKY (SPORTS MEDICINE PROGRAM MANAGER)
(614) 355-6020
Entity
Organization
Contact information
Practice address
584 COUNTY LINE RD W, WESTERVILLE, OH 43082-7245
(614) 355-6090
Mailing address
584 COUNTY LINE RD W, WESTERVILLE, OH 43082-7245
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.004136
OH
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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