Individual
ISAIAH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
17273 OH-104, CHILLICOTHE, OH 45601
(614) 558-1519
Mailing address
PO BOX 207170, DALLAS, TX 75320-7071
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.006913
OH
Other
Enumeration date
07/07/2020
Last updated
05/12/2021
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