National Provider Identifier

Jacob Radlich, ATC, LAT

Jacob Radlich, ATC, LAT is listed in the NPPES registry with a primary specialty of Athletic Trainer in Orchard Park, NY and a listed phone number of (716) 939-4469.

NPI 1649703539Orchard Park, NYAthletic Trainer

Profile Overview

NPI
1649703539
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
April 06, 2017
Last Updated
April 06, 2017

Practice Location

  • 1 Bills Dr
  • Orchard Park, NY 14127-2237

Phone: (716) 939-4469

Mailing Address

  • 34 Briarcliff RD
  • Buffalo, NY 14225-1502

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1649703539
Entity Type
Individual
Last Name
Radlich
First Name
Jacob
Credential
ATC, LAT
Mailing Street Address
34 Briarcliff RD
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14225-1502
Mailing Country
US
Practice Street Address
1 Bills Dr
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127-2237
Practice Country
US
Practice Phone
(716) 939-4469
Enumeration Date
April 06, 2017
Last Updated
April 06, 2017
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)