Individual
MR. RICHARD JOHN JETTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
701 SUPERIOR ST, ROSSFORD, OH 43460-1250
(419) 666-5262
Mailing address
217 KILLARNEY CIR APT B, BOWLING GREEN, OH 43402-5418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004930
OH
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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