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1861187106
LANCE JACOB JORDAN
MOUNTAIN BRK, AL
NPI
1861187106
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2023-04-11
Last Update Date
2023-04-11
Business Address
LANCE JACOB JORDAN ATC
3650 BETHUNE DR
MOUNTAIN BRK, AL 35223-1420
Phone number: 205-903-8496
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Mailing Address
LANCE JACOB JORDAN ATC
3650 BETHUNE DR
MOUNTAIN BRK, AL 35223-1420
Phone number:
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