Individual
KENTON JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1677 STUBBS MILL RD, LEBANON, OH 45036-9657
(740) 646-2027
Mailing address
1677 STUBBS MILL RD, LEBANON, OH 45036-9657
(740) 646-2027
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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