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Individual

JORDAN GREENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC, LAT

Contact information

Practice address
2550 W FM 544, WYLIE, TX 75098-4936
(972) 429-3100
Mailing address
1502 RIVER OAKS CIR APT 228, WYLIE, TX 75098-7897
(903) 821-1612

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000013405
TX
2255A2300X
Athletic Trainer
TX4951
TX

Other

Enumeration date
11/13/2013
Last updated
11/13/2013
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