Individual
JORDAN STITHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1618 N TAYLOR AVE, GRAND ISLAND, NE 68803-2632
(308) 390-9992
Mailing address
1618 N TAYLOR AVE, GRAND ISLAND, NE 68803-2632
(308) 390-9992
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
567
NE
Other
Enumeration date
04/25/2021
Last updated
04/25/2021
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