Individual
JOSEPH PATRICK JORDAN V
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 MARBLE LN, LAFAYETTE HILL, PA 19444-1312
(267) 438-0678
Mailing address
201 MARBLE LN, LAFAYETTE HILL, PA 19444-1312
(267) 438-0678
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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