Individual
MR. JORDAN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC,LAT
Contact information
Practice address
1111 FOREST PARK ST, LAKELAND, FL 33803-1832
(863) 688-2771
Mailing address
2935 WOODLAND HILLS AVE, LAKELAND, FL 33803-4141
(863) 287-4624
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3867
FL
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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