Individual
JORDAN LAXSON CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 BEVERLY HILLS DR, VESTAVIA HILLS, AL 35216-1704
(205) 862-1892
Mailing address
2100 BEVERLY HILLS DR, VESTAVIA HILLS, AL 35216-1704
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
1-162578
AL
Other
Enumeration date
05/10/2021
Last updated
05/10/2021
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