Individual
KETURAH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10700 SIKES PL, CHARLOTTE, NC 28277-8144
(980) 999-0492
Mailing address
1737 YORKDALE DR, CHARLOTTE, NC 28217
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
0000000
NC
376J00000X
Homemaker
Primary
—
NC
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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