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Individual

DAVID JOSEPH JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1903 BATAAN RD APT 12, REDONDO BEACH, CA 90278-1316
(310) 606-1140
Mailing address
1903 BATAAN RD APT 12, REDONDO BEACH, CA 90278-1316
(310) 606-1140

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
48198
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
48198
MASSAGE THERAPY
CA
Enumeration date
06/06/2017
Last updated
07/21/2022
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