NPI 1548901176

Jordan Brook Mockta, ACSMEP

Practitioner Clinical Exercise Physiologist Flagstaff, AZ

Practice location

Address: 1500 E Cedar Ave STE 52, Flagstaff, AZ 86004-1643
Phone: (928) 773-1245
Fax: (928) 773-9429
Mailing address: 5404 E. Cortland Blvd 190, Flagstaff, AZ 86004

Registered specialties

Clinical Exercise Physiologist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Y00000X Licence 1059346 (AZ)

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Registry record

NPI: 1548901176
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Apr 2022
Record last updated: 11 Apr 2022

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.