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1174034938
JORDAN REID JOHNSON
BANNER ELK, NC
NPI
1174034938
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: NC 3602)
Enumeration Date
2017-10-19
Last Update Date
2017-10-19
Business Address
JORDAN REID JOHNSON MS, LAT, ATC
191 MAIN ST
BANNER ELK, NC 28604-9626
Phone number: 828-898-8892
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Mailing Address
JORDAN REID JOHNSON MS, LAT, ATC
PO BOX 128
BANNER ELK, NC 28604-0128
Phone number:
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