Individual
LYNZ JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(715) 897-5411
Mailing address
209905 MALLARD LN, EDGAR, WI 54426-5562
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3495-29
WI
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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