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Individual

MR. JORDAN LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
1579 MALMSTROM AVENUE, NELLIS AFB, NV 89191
(702) 652-1542
Mailing address
1579 MALMSTROM AVENUE, NELLIS AFB, NV 89191
(702) 652-1542

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
07/09/2009
Last updated
07/23/2009
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