National Provider Identifier

Jaclyn Stucker, MA, LAT, ATC

Jaclyn Stucker, MA, LAT, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Geneva, NY and a listed phone number of (315) 481-5698.

NPI 1407213754Geneva, NYAthletic Trainer

Profile Overview

NPI
1407213754
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
January 18, 2016
Last Updated
January 18, 2016

Practice Location

  • 300 Pulteney St
  • Bristol Gymnasium
  • Geneva, NY 14456-3304

Phone: (315) 481-5698

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1407213754
Entity Type
Individual
Last Name
Stucker
First Name
Jaclyn
Credential
MA, LAT, ATC
Mailing Street Address
300 Pulteney St
Mailing Address Line 2
Bristol Gymnasium
Mailing City
Geneva
Mailing State
NY
Mailing ZIP Code
14456-3304
Mailing Country
US
Mailing Phone
(315) 481-5698
Practice Street Address
300 Pulteney St
Practice Address Line 2
Bristol Gymnasium
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456-3304
Practice Country
US
Practice Phone
(315) 481-5698
Enumeration Date
January 18, 2016
Last Updated
January 18, 2016
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)