Individual
DR. JORDAN GLIEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(414) 955-7199
(414) 955-0110
Mailing address
1155 N MAYFAIR RD, MILWAUKEE, WI 53226-3462
(414) 955-7199
(414) 955-0110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
15955
AR
111N00000X
Chiropractor
Primary
5300
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
854483
—
AZ
01
—
Z173626
PTAN
AZ
Enumeration date
01/20/2012
Last updated
07/21/2022
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