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Individual

DESIREE JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3872 PIO NONO AVE, MACON, GA 31206-3042
(478) 219-0968
Mailing address
3900 NORTHSIDE DR, MACON, GA 31210, USA, D15, MACON, GA 31210
(478) 219-0968

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
COA010392
GA

Other

Enumeration date
01/29/2025
Last updated
01/29/2025
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