Individual
JORDAN GODOROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 VITALE AVE, HENDERSON, NV 89002-9208
(702) 376-2838
Mailing address
165 VITALE AVE, HENDERSON, NV 89002-9208
(702) 376-2838
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/10/2013
Last updated
06/02/2014
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