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1801498175
JACK SCODIUS
EAST LANSING, MI
NPI
1801498175
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2020-11-12
Last Update Date
2020-11-12
Business Address
JACK SCODIUS
771 CHESTNUT RD
EAST LANSING, MI 48824-3434
Phone number: 517-353-4412
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Mailing Address
JACK SCODIUS
912 N BURNING BUSH LN
MOUNT PROSPECT, IL 60056-1802
Phone number:
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