Individual
MISTY STARLENE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 BALLYSHANNON DR, DACULA, GA 30019-6529
(470) 429-8808
Mailing address
610 BALLYSHANNON DR, DACULA, GA 30019-6529
(470) 429-8808
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/29/2016
Last updated
10/29/2016
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