Organization
ANTHONY L. JORDAN HEALTH CORPORATION
Active
Parent organization
ANTHONY L. JORDAN HEALTH CORPORATION
Other names
Jordan at CCIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANTHONY L. JORDAN HEALTH CORPORATION
Authorized official
BRIDGETTE WIEFLING MD (PRESIDENT/CEO)
(585) 423-2878
Entity
Organization
Contact information
Practice address
120 N MAIN ST, SUITE 11, CANANDAIGUA, NY 14424-1258
(585) 396-6980
Mailing address
82 HOLLAND STREET, ROCHESTER, NY 14605-2131
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/06/2012
Last updated
09/07/2012
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