Individual
MR. GERALD STEPHEN JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1417 MAPLE ST, CLEVELAND, MS 38733-0001
(662) 846-4300
(662) 846-4297
Mailing address
DSU PO BOX 683, CLEVELAND, MS 38733-0001
(662) 846-4300
(662) 846-4297
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0328
MS
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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