JORDAN GONZALES

TAHLEQUAH, OK
NPI1154708626
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OK  830)
Enumeration Date2015-05-04
Last Update Date2015-05-04
Business Address
-- JORDAN GONZALES ATC, LAT
603 N GRAND AVE
TAHLEQUAH, OK 74464-2302
Phone number: 918-444-3921
Mailing Address
-- JORDAN GONZALES ATC, LAT
1249 S 103RD EAST AVE
TULSA, OK 74128-4631
Phone number: 918-859-9098
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