Individual
ALIZA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 1848, UNIVERSITY, MS 38677-1848
(662) 915-7901
Mailing address
2515 ALLEN RD, SMITHDALE, MS 39664-4081
(601) 384-6501
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/01/2024
Last updated
06/01/2024
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