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Individual

SUSAN A JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED DIETITION

Contact information

Practice address
1010 SOUTH, 7650 EAST, CROW AGENCY, MT 59022-0022
(406) 638-3553
(406) 638-3553
Mailing address
PO BOX 108, HARDIN, MT 59034-0108
(406) 638-3553
(406) 638-3569

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06018
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2210068
MT
01
DT06018
TEXAS STATE BOARD
TX
Enumeration date
09/23/2006
Last updated
04/10/2008
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