Provider Demographics
NPI:1932876182
Name:ROHR, JORDAN KYLE (ATC, LAT, MED)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:KYLE
Last Name:ROHR
Suffix:
Gender:M
Credentials:ATC, LAT, MED
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:ROHR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAT, ATC, MED
Mailing Address - Street 1:700 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3513
Mailing Address - Country:US
Mailing Address - Phone:215-605-1452
Mailing Address - Fax:
Practice Address - Street 1:700 NORWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3513
Practice Address - Country:US
Practice Address - Phone:215-605-1452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2758OtherATHLETIC TRAINER