Individual
BRENNAN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2647 MILLER ST, PHILADELPHIA, PA 19125-2328
(609) 330-1788
Mailing address
2647 MILLER ST, PHILADELPHIA, PA 19125-2328
(609) 330-1788
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
09/29/2015
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