Individual
VERNON JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
74 WESTMINISTER DR, LITTLE ROCK, AR 72209-2949
(501) 414-8224
Mailing address
PO BOX 13624, MAUMELLE, AR 72113-0624
(501) 414-8224
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
172A00000X
Driver
—
—
172V00000X
Community Health Worker
Primary
—
—
222Q00000X
Developmental Therapist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
2255A2300X
Athletic Trainer
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
3747A0650X
Attendant Care Provider
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2016
Last updated
05/14/2016
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