Individual
JAN A JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR REPLACEMENT
Contact information
Practice address
1615 2ND AVE N, COLUMBUS, MS 39701-4927
(662) 244-7000
Mailing address
1615 2ND AVE N, COLUMBUS, MS 39701-4927
(662) 244-7000
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
717
MS
Other
Enumeration date
03/04/2018
Last updated
03/04/2018
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