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1003149840
JONATHAN JORDAN
LAS VEGAS, NM
NPI
1003149840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2009-09-11
Last Update Date
2009-09-11
Business Address
-- JONATHAN JORDAN
700 FRIEDMAN AVE
LAS VEGAS, NM 87701-4231
Phone number: 505-454-5100
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Mailing Address
-- JONATHAN JORDAN
3695 HOT SPRINGS BLVD
LAS VEGAS, NM 87701-9549
Phone number: 505-454-5100
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