Individual
JORDAN WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
705 QUINCE PL, CHESAPEAKE, VA 23320-0769
(757) 410-2793
Mailing address
5272 HOLY NECK RD, SUFFOLK, VA 23437-9399
(757) 633-1119
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557875
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0104557875
BOARD OF MEDICINE
VA
Enumeration date
11/30/2022
Last updated
11/30/2022
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