Individual
JORDAN CHASE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1800 UNIVERSITY DR N, FARGO, ND 58102-2241
(701) 730-6243
Mailing address
818 10TH AVE N, FARGO, ND 58102-3638
(734) 972-3960
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
883-20
ND
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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