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Individual

MR. JORDAN DORRIEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
402 BLUEBIRD BLVD, FORT VALLEY, GA 31030-5088
(478) 825-2021
Mailing address
800 GUNN RD, APT. 1028, CENTERVILLE, GA 31028-8556
(973) 879-5172

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002316
GA

Other

Enumeration date
09/12/2015
Last updated
09/12/2015
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