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1093086373
JORDAN LAWRENCE
EAGLE BUTTE, SD
NPI
1093086373
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: SD r044810)
Enumeration Date
2012-01-19
Last Update Date
2012-01-19
Business Address
-- JORDAN LAWRENCE Nurse
312 MAIN ST.
EAGLE BUTTE, SD 57625
Phone number: 605-964-7724
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Mailing Address
-- JORDAN LAWRENCE Nurse
312 MAIN ST.
EAGLE BUTTE, SD 57625
Phone number:
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