Individual
MR. JORDAN LEE HARTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
906 E 1ST ST, THIBODAUX, LA 70301-6701
(985) 448-4837
Mailing address
9240 MAIN ST, HOUMA, LA 70363-5371
(985) 381-3724
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/11/2016
Last updated
12/11/2016
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