Individual
DR. JACKIE L BUELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD,RD, ATC
Contact information
Practice address
2050 KENNY RD, SPORTS MEDICINE, GYMNASIUM SPACE EXAM RM 1, COLUMBUS, OH 43221-3502
(614) 293-3600
Mailing address
2050 KENNY RD, SPORTS MEDICINE, 3RD FLOOR, COLUMBUS, OH 43221-3502
(614) 293-3600
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD.5999
OH
2255A2300X
Athletic Trainer
AT000022
OH
Other
Enumeration date
05/04/2007
Last updated
07/17/2015
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