Individual
MR. NATHAN JAMES JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, OTR
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4461026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41225900
—
WI
Enumeration date
02/26/2007
Last updated
06/07/2018
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