Individual
JACQUELINE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5500
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5500
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
S4Q7J8J5
AL
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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