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1093979171
MICHAEL JORDAN
MEDFORD, OR
NPI
1093979171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: OR 8217)
Enumeration Date
2008-07-17
Last Update Date
2008-07-17
Business Address
-- MICHAEL JORDAN
835 CRATER LAKE AVE
MEDFORD, OR 97504-6505
Phone number: 541-773-7717
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Mailing Address
-- MICHAEL JORDAN
835 CRATER LAKE AVE
MEDFORD, OR 97504-6505
Phone number:
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