Individual
TAKENYA LACOLE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2231 DAWSON RD STE IJ, ALBANY, GA 31707-3227
(229) 938-2083
(888) 780-7250
Mailing address
2231 DAWSON RD STE IJ, ALBANY, GA 31707-3227
(229) 938-2083
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
12/27/2024
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