Individual
JORDAN THOMAS MADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7036 GRENVILLE RD, TALLAHASSEE, FL 32309-9002
(850) 284-4346
Mailing address
7036 GRENVILLE RD, TALLAHASSEE, FL 32309-9002
(850) 284-4346
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3293
CA
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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