Individual
MR. JORDAN DREW BETTLEYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, EP-C
Contact information
Practice address
5400 RAMSEY ST, FAYETTEVILLE, NC 28311
(910) 630-7000
Mailing address
408 TARTAN CT, FAYETTEVILLE, NC 28311-1694
(570) 274-6387
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
003597
NY
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
3994
NC
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
RTO000311
PA
Other
Enumeration date
06/20/2018
Last updated
08/08/2018
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