Individual
JORDAN DAVID CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
278 VT 149, WEST PAWLET, VT 05775-9798
(802) 645-0580
Mailing address
183 FITZGERALD RD, MIDDLETOWN SPRINGS, VT 05757-4119
(802) 558-7466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031401
VT
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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