Individual
JORDON WEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT,ATC
Contact information
Practice address
878 HIGHWAY 411 N, ETOWAH, TN 37331-1912
(423) 263-7070
(423) 263-7077
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 285-6647
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1926
TN
Other
Enumeration date
11/11/2014
Last updated
08/07/2015
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