Individual
CHARICE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
939 THORNTON RD, LITHIA SPRINGS, GA 30122-2634
(770) 948-5400
Mailing address
PO BOX 761, LITHIA SPRINGS, GA 30122-0761
(904) 566-8851
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2394
GA
Other
Enumeration date
10/19/2012
Last updated
05/21/2014
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