Individual
JORDAN LEE KANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
172 E MERRITT ST STE C, PRESCOTT, AZ 86301-2027
(928) 642-5382
Mailing address
172 E MERRITT ST STE C, PRESCOTT, AZ 86301-2027
(928) 642-5382
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-29426
AZ
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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