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1891239901
JORDAN ELLIS
OMAHA, NE
NPI
1891239901
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2016-12-08
Last Update Date
2016-12-08
Business Address
-- JORDAN ELLIS
5814 S 105TH ST
OMAHA, NE 68127-2909
Phone number: 402-321-6867
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Mailing Address
-- JORDAN ELLIS
5814 S 105TH ST
OMAHA, NE 68127-2909
Phone number: 402-321-6867
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