Jordan Elizabeth Blough, ATC
Specialist/Technologist, Athletic Trainer in Jefferson, LA. Individual provider (NPI-1).
NPI number1982190591
StatusActive
Last updated in NPPESJul 6, 2018
Details
- NPI
- 1982190591
- Entity type
- Individual (NPI-1)
- Name
- Jordan Elizabeth Blough
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2018
- Last updated
- Jul 6, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | ATH.200209 | LA | Yes |
Practice location
1201 S Clearview PkwyJefferson, LA 70121-1015
Phone 504-736-4800
Mailing address
1212 Focis StMetairie, LA 70005-2318
Phone 941-356-7483
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