Individual
JENNIFER ANN DYSZKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
111 W JEFFERSON BLVD, SUITE 100, SOUTH BEND, IN 46601-1994
(574) 289-4764
Mailing address
1855 ALTGELD ST, SOUTH BEND, IN 46614-1603
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36000645A
IN
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
01/22/2007
Last updated
07/27/2023
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