Individual
ANTHONY JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2030 KIPLING DR, DAYTON, OH 45406-3822
(937) 430-0720
Mailing address
2030 KIPLING DR, DAYTON, OH 45406-3822
(937) 430-0720
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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