Individual
JORDIN ASHLEE BROUHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
13847 W 63RD ST STE 2, SHAWNEE, KS 66216-3800
(913) 962-7770
(913) 962-7775
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2019032147
MO
2255A2300X
Athletic Trainer
Primary
24-01036
KS
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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