Individual
JORDAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19710 CHERRY HILL ST, SOUTHFIELD, MI 48076-1061
(248) 514-9024
Mailing address
19710 CHERRY HILL ST, SOUTHFIELD, MI 48076-1061
(248) 514-9024
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6801107130
MI
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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