Individual
DR. JORDAN ZANE TACKTILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
222 WALNUT AVE SW, ROANOKE, VA 24016-4723
(540) 344-3668
Mailing address
222 WALNUT AVE SW, ROANOKE, VA 24016-4723
(540) 344-3668
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103301083
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3534
FL
Other
Enumeration date
05/25/2012
Last updated
01/10/2022
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