Individual
JORDAN BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 BEAMAN ST, CLINTON, NC 28328-2603
(910) 592-8511
Mailing address
607 BEAMAN ST, CLINTON, NC 28328-2603
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NC
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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