Jordan Kyle Wall
Jordan Kyle Wall is an Athletic Trainer in Virginia Beach, Virginia. Practices as a sole proprietor. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
1904 Fairweather CtVirginia Beach, VA 23456-5318
Phone: (757) 613-0390
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|---|
| Athletic Trainer | Taxonomy 2255A2300X |
Record details
| NPI number | 1548853658 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 19, 2021 |
| Last updated in NPPES | February 19, 2021 |
| Certification date | February 19, 2021 |
| Mailing address | 1904 Fairweather Ct, Virginia Beach, VA 23456-5318 |
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