Individual
GRANT JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
335 NE 4TH ST, BEND, OR 97701-5162
(541) 668-7506
Mailing address
63265 SILVIS RD, BEND, OR 97701-9743
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27416
OR
Other
Enumeration date
12/20/2022
Last updated
12/20/2022
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