NPI 1215582192

Jordan D Lange, ATC

Practitioner Athletic Trainer Saint Cloud, MN

Practice location

Address: 4020 Clearwater Rd APT 206, Saint Cloud, MN 56301-8601
Phone: (218) 396-0160

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Minnesota →

Registry record

NPI: 1215582192
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Aug 2019
Record last updated: 7 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.