Individual
JORDYNNE CARMICHAEL-GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
515 FAIRVIEW AVE, CANON CITY, CO 81212-2863
(719) 275-0655
Mailing address
313 BELLOWS CT, CANON CITY, CO 81212-9515
(570) 447-9263
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0006537
CO
Other
Enumeration date
11/03/2020
Last updated
04/23/2024
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