Individual
DR. KENNETH WESLEY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
705 NORTH FRASER ST, GEORGETOWN, SC 29442-0958
(843) 235-0546
(843) 527-8353
Mailing address
705 NORTH FRASER STREET, GEORGETOWN, SC 29442-0958
(843) 235-0546
(843) 527-8353
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3056
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GCH507
—
SC
Enumeration date
03/28/2006
Last updated
07/16/2008
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