Individual
JORDAN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(618) 604-2833
Mailing address
1157 N MOORE ST, WATERLOO, IL 62298-5409
(618) 604-2833
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
2015036804
MO
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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