Individual
JORDAN MARIE INZANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1195 HEWITT ST, BROCKWAY, PA 15824-1808
(814) 771-9394
Mailing address
1195 HEWITT ST, BROCKWAY, PA 15824-1808
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/06/2017
Last updated
05/05/2018
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