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Individual

MICHAEL CHRISTOPHER JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT ATC

Contact information

Practice address
1325 MCFARLAND BLVD, NORTHPORT, AL 35476-3270
(205) 333-4766
(205) 333-4776
Mailing address
5122 BLACKSTONE LN, NORTHPORT, AL 35473-1092
(205) 603-9961
(205) 333-4776

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1245
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245
ALABAMA BOARD OF ATHLETIC TRAINERS
AL
Enumeration date
06/16/2016
Last updated
06/16/2016
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