Individual
BROOK JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
514 COYOTE CIR, BLACK HAWK, CO 80422-8712
(303) 408-6138
Mailing address
514 COYOTE CIR, BLACK HAWK, CO 80422-8712
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
12/22/2021
Last updated
12/22/2021
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