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Individual
MARIAH JORDAN SVANTESSON
Active
Individual
MARIAH JORDAN SVANTESSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
3098
SC
363A00000X
Physician Assistant
Primary
PA.0006527
CO
363AS0400X
Surgical Physician Assistant
3098
SC
Other
Enumeration date
10/30/2018
Last updated
02/01/2023
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