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Individual
MR. JORDAN ALEXANDER SMITH
Active
Individual
MR. JORDAN ALEXANDER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5646
SC
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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