Individual
JORDAN OBERBRECKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
605 WASHINGTON ST, FAYETTE, IA 52142-9206
(319) 480-6191
Mailing address
108 S OAK ST, WYOMING, IA 52362-7793
(319) 480-6191
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001066
IA
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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