Individual
ELJIN JON GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS LAT ATC
Contact information
Practice address
2004 STONE PL, CLOVIS, NM 88101-8667
(505) 903-1661
Mailing address
2004 STONE PL, CLOVIS, NM 88101-8667
(505) 903-1661
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT712
NM
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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