Individual
JORDAN GRISTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
427 N WENDOVER RD, CHARLOTTE, NC 28211-1064
(704) 304-0620
Mailing address
2104 PARK RD APT 3, CHARLOTTE, NC 28203-5963
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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