Individual
JORDAN HOLLISTER JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(947) 521-8030
Mailing address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(947) 521-8030
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5151016805
MI
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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