Individual
MRS. AMY B JORDAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2525 W 4TH ST, MANSFIELD, OH 44906-1208
(419) 755-5109
Mailing address
2229 BETHANY LN, MARION, OH 43302-8365
(419) 496-3769
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT-1591
OH
Other
Enumeration date
04/17/2006
Last updated
07/08/2007
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