Individual
JORDAN GOBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
603 HCR 1231, WHITNEY, TX 76692-2102
(830) 660-0500
Mailing address
603 HCR 1231, WHITNEY, TX 76692-2102
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
STUDENT
—
Enumeration date
03/03/2019
Last updated
03/03/2019
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