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1013347640
JORDAN PERSONIUS
GRANTS PASS, OR
NPI
1013347640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA165526)
Enumeration Date
2013-11-18
Last Update Date
2013-11-18
Business Address
-- JORDAN PERSONIUS PA
500 SW RAMSEY AVE
GRANTS PASS, OR 97527-5554
Phone number: 541-789-4281
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Mailing Address
-- JORDAN PERSONIUS PA
2620 E BARNETT RD SUITE H
MEDFORD, OR 97504-8344
Phone number: 541-789-4281
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