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Individual
MICHAEL CHRISTOPHER JORDAN
Active
Individual
MICHAEL CHRISTOPHER JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1245
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245
ALABAMA BOARD OF ATHLETIC TRAINERS
AL
Enumeration date
06/16/2016
Last updated
06/16/2016
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