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1245693209
JORDAN TEBODA
ATLANTA, GA
NPI
1245693209
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA AT002448)
Enumeration Date
2016-03-29
Last Update Date
2016-03-29
Business Address
-- JORDAN TEBODA ATC
59 EXECUTIVE PARK S
ATLANTA, GA 30329-2208
Phone number: 404-778-6330
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Mailing Address
-- JORDAN TEBODA ATC
8259 WICKER AVE
SAINT JOHN, IN 46373-8878
Phone number: 219-365-6560
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