Individual
JORDAN BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 N PLAIN RD, JACKSONVILLE, NC 28546-6760
(910) 298-2331
Mailing address
878 LYMAN RD, BEULAVILLE, NC 28518-7628
(910) 789-1897
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15401
NC
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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