Individual
JORDAN PERSONIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 789-4281
Mailing address
2620 E BARNETT RD, SUITE H, MEDFORD, OR 97504-8344
(541) 789-4281
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA165526
OR
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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