Individual
JORDAN KELLY WEITZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
1919 LAKE AVE, PLYMOUTH, IN 46563-7830
(574) 948-4800
Mailing address
1371 HOLLOWAY DR, PLYMOUTH, IN 46563-3174
(641) 751-1416
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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