Individual
MRS. JORDAN JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
516 N 14TH ST APT 12, MANHATTAN, KS 66502-4172
(913) 246-2624
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2529
TN
Other
Enumeration date
09/30/2018
Last updated
07/08/2019
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