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1194147975
JORDAN OBERBRECKLING
FAYETTE, IA
NPI
1194147975
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IA 001066)
Enumeration Date
2014-01-13
Last Update Date
2014-01-13
Business Address
-- JORDAN OBERBRECKLING ATC, LAT
605 WASHINGTON ST
FAYETTE, IA 52142-9206
Phone number: 319-480-6191
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Mailing Address
-- JORDAN OBERBRECKLING ATC, LAT
108 S OAK ST
WYOMING, IA 52362-7793
Phone number: 319-480-6191
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