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Individual
DR. JEREMY SCOTT JORDAN
Active
Individual
DR. JEREMY SCOTT JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1061
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03356557
—
MS
01
—
1061
MS DOCTORATE OF CHIROPRACTIC LICENSE NUMBER
MS
Enumeration date
12/15/2006
Last updated
04/17/2024
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