Individual
DR. JORDAN WINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
106 E WATAUGA AVE, JOHNSON CITY, TN 37601-4628
(423) 928-5771
(423) 928-1424
Mailing address
106 E WATAUGA AVE, JOHNSON CITY, TN 37601-4628
(423) 928-5771
(423) 928-1424
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2091
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14980
AUDIOLOGY LICENSURE
NC
05
—
Q076394
—
TN
Enumeration date
06/11/2021
Last updated
05/03/2023
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