Individual
STACEY LYNN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPO, CPO, BOC OP
Contact information
Practice address
441 S WESTERN ST, AMARILLO, TX 79106-8555
(806) 353-7276
(806) 353-7539
Mailing address
PO BOX 3702, AMARILLO, TX 79116-3702
(806) 353-7276
(806) 353-7539
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
488
TX
224P00000X
Prosthetist
488
TX
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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