Individual
ROLLIE JORDAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3125 N BROADWAY, LOS ANGELES, CA 90031-2703
(213) 482-6400
Mailing address
3125 N BROADWAY, LOS ANGELES, CA 90031-2703
(213) 482-6400
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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