Individual
JORDAN CORLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
5250 BAYOU WILLOW DR, BEAUMONT, TX 77705-7054
(409) 658-5230
Mailing address
2039 DOWLEN RD APT 2, BEAUMONT, TX 77706-3345
(409) 658-5230
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6026
TX
2255A2300X
Athletic Trainer
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Other
Enumeration date
06/28/2017
Last updated
07/21/2022
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