Individual
MELANIE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 CLINIC AVE, SUITE 101, CARROLLTON, GA 30117-4401
(678) 601-5220
Mailing address
705 DALLAS HWY, SUITE 301, VILLA RICA, GA 30180-1247
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
72107
GA
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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