Individual
CORRINE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
517 E DIVISION ST, FOND DU LAC, WI 54935-3735
(920) 921-6800
Mailing address
355 MARY LEE DR, FOND DU LAC, WI 54935-1847
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
447-24
WI
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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