Individual
DR. JORDAN CHRISTOPHER RENNICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3057
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
32087
NE
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
32087
NE
Other
Enumeration date
04/21/2018
Last updated
05/21/2024
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