Individual
DAQUAN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1319 ASHBOURNE DR, LYNCHBURG, VA 24501-5305
(336) 398-0735
Mailing address
1319 ASHBOURNE DR, LYNCHBURG, VA 24501-5305
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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