Individual
CHARLES JERMAINE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NREMT
Contact information
Practice address
LYSTER ARMY HEALTH CLINIC, BUILDING 301, ANDREWS AVENUE, FORT RUCKER, AL 36362-5333
(334) 255-7603
Mailing address
LYSTER ARMY HEALTH CLINIC, BUILDING 301, ANDREWS AVENUE, FORT RUCKER, AL 36362-5333
(334) 255-7603
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E1485589
TX
Other
Enumeration date
08/01/2017
Last updated
07/21/2022
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