Individual
MR. JORDAN LEGENDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 WEEPING WILLOW DRIVE, APT. I, LYNCHBURG, VA 24501
(503) 866-1425
Mailing address
2900 WEEPING WILLOW DR, APT. I, LYNCHBURG, VA 24501-3944
(503) 866-1425
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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