Individual
JORDAN SHIMODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 PATRIOT PL, FOXBOROUGH, MA 02035-1374
(808) 387-9375
Mailing address
85 WASHINGTON ST APT 7301, PLAINVILLE, MA 02762-5212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000032108
—
2255A2300X
Athletic Trainer
2150
AL
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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