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Individual

JORDAN WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
801 17TH AVE N, FARGO, ND 58102-2226
(701) 446-2447
Mailing address
4601 36TH AVE S APT 102, FARGO, ND 58104-5200

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
11/07/2018
Last updated
11/07/2018
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