Individual
DARREL JORDAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7648 VIA PASEO AVE, LAS VEGAS, NV 89128-2621
(702) 557-9849
Mailing address
7648 VIA PASEO AVE, LAS VEGAS, NV 89128-2621
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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