Individual
JORDAN EDWARD KACZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
Mailing address
400 E 3RD ST, MSS 6AV1-PE, DULUTH, MN 55805-1951
(218) 786-3146
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/16/2019
Last updated
11/07/2019
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