Individual
JORDAN LORENZO HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
254 MARIGOLD ST, MOUNT AIRY, LA 70076-2119
(985) 817-3432
Mailing address
254 MARIGOLD ST, MOUNT AIRY, LA 70076-2119
(985) 817-3432
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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