Individual
MR. RONALD EDWARD JORDAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.-B.H.R.S.
Contact information
Practice address
647 N KICKAPOO AVE, SHAWNEE, OK 74580
(918) 470-3483
Mailing address
647 N KICKAPOO AVE, SHAWNEE, OK 74580
(918) 470-3483
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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