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Individual

MATT JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3112 HUMBOLDT AVE S, APARTMENT 4, MINNEAPOLIS, MN 55408-2683
(612) 508-4967
Mailing address
3112 HUMBOLDT AVE S, APARTMENT 4, MINNEAPOLIS, MN 55408-2683
(612) 508-4967

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2457
MN

Other

Enumeration date
11/13/2014
Last updated
11/13/2014
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