Individual
JORDAN FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 TAYLOR RD, MONTGOMERY, AL 36117-3512
(334) 213-6255
Mailing address
254 DEBBIE DR, DEATSVILLE, AL 36022-2567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-140564
AL
Other
Enumeration date
08/19/2018
Last updated
08/19/2018
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