Individual
JORDAN LEIGH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 S HIGHWAY 6, GRETNA, NE 68028-7970
(402) 332-3446
Mailing address
3533 N 175TH CT APT 206, OMAHA, NE 68116-2733
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2109
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2109
NEBRASK LICENSE
NE
Enumeration date
07/06/2017
Last updated
07/06/2017
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