Individual
JORDAN L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT STUDENT
Contact information
Practice address
4084 GRAYFRIARS LN, COLUMBUS, OH 43224-1758
(614) 749-1355
Mailing address
4084 GRAYFRIARS LN, COLUMBUS, OH 43224-1758
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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