Individual
JORDAN DIMEDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
583 SHOEMAKER RD, KING OF PRUSSIA, PA 19406-4201
(484) 681-2170
Mailing address
583 SHOEMAKER RD STE 230, KING OF PRUSSIA, PA 19406-4238
(484) 681-2170
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-141092
NJ
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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