Individual
MR. JORDAN W. CARLISLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
USCG HQ, COMDT, 2100 2ND STREET, RM 5314, WASHINGTON, DC 20593-0001
(860) 444-8402
Mailing address
USCG HQ, COMDT(CG-1122), 2100 2ND STREET, RM 5314, WASHINGTON, DC 20593-0001
(860) 444-8402
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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