Individual
DR. JORDAN FAISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
900 E RIVERVIEW EXPY, WISCONSIN RAPIDS, WI 54494-5482
(715) 631-7177
Mailing address
900 E RIVERVIEW EXPY, WISCONSIN RAPIDS, WI 54494-5482
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
19200-40
WI
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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