Individual
JORDAN SIDDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1484 N M 52, OWOSSO, MI 48867-1235
(770) 373-5822
Mailing address
1555 INDUSTRIAL DR, OWOSSO, MI 48867-9775
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
02/12/2018
Last updated
11/01/2023
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