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Individual
JORDAN DULAY ELLFELDT
Active
Individual
JORDAN DULAY ELLFELDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-34853-TLG
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2021
Last updated
05/26/2022
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