Healthcare Provider Details

I. General information

NPI: 1013129097
Provider Name (Legal Business Name): JON ARTHUR SANTINI JR. ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LANTERN LN
PLAIN CITY OH
43064-2126
US

IV. Provider business mailing address

220 LANTERN LN
PLAIN CITY OH
43064-2126
US

V. Phone/Fax

Practice location:
  • Phone: 614-873-1317
  • Fax: 614-873-5616
Mailing address:
  • Phone: 614-873-1317
  • Fax: 614-873-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT000953
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: