Individual
JORDAN SYMONE STUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2836 PAM PL, REX, GA 30273-2337
(678) 510-8837
Mailing address
2836 PAM PL, REX, GA 30273-2337
(678) 510-8837
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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