JORDAN PHENICIE

SPRINGFIELD, MO
NPI1114428547
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MO  2018003312)
Enumeration Date2018-02-21
Last Update Date2018-12-27
Business Address
JORDAN PHENICIE PA
3555 S NATIONAL AVE
SPRINGFIELD, MO 65807-7310
Phone number: 417-875-3800
Mailing Address
JORDAN PHENICIE PA
PO BOX 9007
SPRINGFIELD, MO 65808-9007
Phone number: 417-875-3000
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