Duecker, Jody R

Duecker, Jody R is an individual health care provider with primary practice located at 19600 N Park Blvd , Shaker Heights OH 44122-1825. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Duecker, Jody R can be contacted via phone (216) 320-8796.

Contact Information

Primary practice address
19600 N Park Blvd Shaker Heights OH 44122-1825
Phone: (216) 320-8796
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 2000007511 Ohio

Profile Details

NPI number 1033692587
LBN Legal business name Duecker, Jody R
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2018
Last updated Sep 11th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033692587 NPPES
Ohio MEDICAID 2000007511

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