Individual
LISA MARIE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
140 COMMONWEALTH AVE, STE 104, DANVERS, MA 01923-3624
(978) 777-6544
Mailing address
140 COMMONWEALTH AVE, STE 104, DANVERS, MA 01923-3624
(978) 777-6544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4583
MA
Other
Enumeration date
02/25/2013
Last updated
04/12/2016
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