Individual
JORDEN RAE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 W FIRESTORM WAY, GLENDALE, AZ 85306-3216
(602) 489-5300
Mailing address
21150 N TATUM BLVD APT 3037, PHOENIX, AZ 85050-7237
(480) 204-3884
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-009247
AZ
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2018
Last updated
09/21/2022
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