Individual
JORDAN TEBODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
59 EXECUTIVE PARK S, ATLANTA, GA 30329-2208
(404) 778-6330
(404) 778-6370
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6560
(219) 365-6561
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002448
GA
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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