Individual
JORDAN HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7731 E NORTHERN LIGHTS BLVD STE 220, ANCHORAGE, AK 99504-3572
(907) 280-9991
Mailing address
609 W EDINBOROUGH DR, PALMER, AK 99645-6513
(907) 521-6482
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
121843
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121843
AK LMT LICENSE
AK
Enumeration date
08/15/2018
Last updated
08/15/2018
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