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Individual

JORDAN KAY LYLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
15 DAHLIA ST, WACO, TX 76708-9633
(916) 295-8281
Mailing address
15 DAHLIA ST, WACO, TX 76708-9633
(916) 295-8281

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7989
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/24/2019
Last updated
09/24/2024
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