Individual
JAKE REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1906 COLLEGE HEIGHTS BLVD, BOWLING GREEN, KY 42101-1000
(270) 745-3542
Mailing address
1906 COLLEGE HEIGHTS BLVD, BOWLING GREEN, KY 42101-1001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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