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1225814759
JACOB JOHN/JORDAN JAMES
MEDFORD, OR
NPI
1225814759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-08-31
Last Update Date
2023-08-31
Business Address
JACOB JOHN/JORDAN JAMES
300 W MAIN ST
MEDFORD, OR 97501-2756
Phone number: 541-772-1777
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Mailing Address
JACOB JOHN/JORDAN JAMES
5530 AZALEA DR
GRANTS PASS, OR 97526-8227
Phone number:
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