Individual
MISS JORDAN GRACE RICHMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
651 E FOOTHILL BLVD, GLENDORA, CA 91741-2713
(909) 731-5934
Mailing address
651 E FOOTHILL BLVD, GLENDORA, CA 91741-2713
(909) 731-5934
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1510
AZ
2255A2300X
Athletic Trainer
—
CA
Other
Enumeration date
01/26/2016
Last updated
10/26/2016
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