Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JORDAN LIGHT
ActiveJORDAN LIGHT is a Athletic Trainer healthcare provider located in WILMORE, Kentucky. NPI 1114305620 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · WILMORE, KY
Registration Details
- NPI Number
- 1114305620
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 16, 2015 (11.256174896363 yrs)
- Last Updated
- May 16, 2015
- License
-
AT1174 (KY)
Practice Information
- Address
-
1 MACKLEM DRWILMORE, KY, 403901152Browse KY providers · Browse ZIP 40390
- Phone
- 3607730106
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.