Individual
JORDAN RAY DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
110 W FAIRVIEW RD, CULPEPER, VA 22701-2240
(540) 718-0386
Mailing address
110 W FAIRVIEW RD, CULPEPER, VA 22701-2240
(540) 718-0386
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000036034
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
—
Enumeration date
07/09/2019
Last updated
07/09/2019
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