Individual
JARED CORDUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3009 PRINCE STREET, SITE 46, CLOVIS, NM 88101
(217) 415-0855
Mailing address
PO BOX 5751, CLOVIS, NM 88102-5751
(217) 415-0855
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
07/22/2022
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