Individual
JORDAN ELIZABETH FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1755 HIGHWAY 34 E, NEWNAN, GA 30265-5631
(770) 254-7850
Mailing address
1755 HIGHWAY 34 E, NEWNAN, GA 30265-5631
(770) 254-7850
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002715
GA
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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