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Individual

DR. JOHN S. JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
300 N MAIN ST STE C, CROWN POINT, IN 46307-3281
(219) 662-7711
(219) 662-7740
Mailing address
300 N MAIN ST STE C, CROWN POINT, IN 46307-3281
(219) 662-7711
(219) 662-7740

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001394
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000184405
ANTHEM BLUE CROSS BLUE SH
IN
05
100147680
IN
05
351875464100
IN
Enumeration date
01/12/2007
Last updated
11/22/2011
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