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1255997748
AUTUMN JORDAN
BLACKSBURG, VA
NPI
1255997748
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-05-10
Last Update Date
2019-05-10
Business Address
AUTUMN JORDAN MD
3700 S MAIN ST
BLACKSBURG, VA 24060-7017
Phone number: 540-953-3528
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Mailing Address
AUTUMN JORDAN MD
PO BOX 287
TERRA CEIA, FL 34250-0287
Phone number: 978-886-2788
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