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1215582192
JORDAN D LANGE
SAINT CLOUD, MN
NPI
1215582192
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-08-07
Last Update Date
2019-08-07
Business Address
Mr. JORDAN D LANGE ATC
4020 CLEARWATER RD APT 206
SAINT CLOUD, MN 56301-8601
Phone number: 218-396-0160
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Mailing Address
Mr. JORDAN D LANGE ATC
4020 CLEARWATER RD APT 206
SAINT CLOUD, MN 56301-8601
Phone number: 218-396-0160
Copy
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