Organization
DR. JOURDAN NICHOLLS, DPM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOURDAN CLIVE NICHOLLS DPM (PHYSICIAN)
(509) 582-2057
Entity
Organization
Contact information
Practice address
7103 W GRANDRIDGE BLVD, SUITE F, KENNEWICK, WA 99336-6713
(509) 582-2057
(509) 374-4945
Mailing address
7103 W GRANDRIDGE BLVD, SUITE F, KENNEWICK, WA 99336-6713
(509) 582-2057
(509) 374-4945
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO 549
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1101377
—
WA
Enumeration date
07/14/2010
Last updated
07/14/2010
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