Individual
THEODORE R. JORDAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5131 BEACON HILL RD, SUITE 200A, COLUMBUS, OH 43228-4442
(614) 878-8034
Mailing address
200 BRADENTON AVE, DUBLIN, OH 43017-7515
(614) 793-1980
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
34-00-5892
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0190323
—
OH
Enumeration date
06/01/2006
Last updated
07/08/2007
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