Jordan Gonzales, ATC, LAT

NPI #1154708626 in Tahlequah, Oklahoma

Provider Information

NPI Number
1154708626
Entity Type
Individual
Name
Jordan Gonzales, ATC, LAT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC, LAT
Enumeration Date
May 4, 2015
Last Updated
May 4, 2015

Practice Location

Address
603 N GRAND AVE
ZIP Code
74464-2302
Phone
(918) 444-3921

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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