Individual
MR. JORDAN PAUL LEEP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1500 S UNIVERSITY PARKS DR, WACO, TX 76706-1211
(254) 710-1021
Mailing address
1825 S 5TH ST, APT 22, WACO, TX 76706-2409
(937) 215-0236
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000004553
NATABOC
—
Enumeration date
08/19/2010
Last updated
08/19/2010
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