Individual
MS. DESTINY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1332 SOUTHERN DR, STATESBORO, GA 30460-1360
(912) 478-4636
Mailing address
PO BOX 1075, SWAINSBORO, GA 30401-1075
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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