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1275284598
JORDAN RILEY JACK
AMES, IA
NPI
1275284598
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-01-18
Last Update Date
2022-01-18
Business Address
JORDAN RILEY JACK
223 FORKER BUILDING 534 WALLACE RD
AMES, IA 50011-0001
Phone number: 515-783-8297
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Mailing Address
JORDAN RILEY JACK
2608 EAGLE POINT CT
DES MOINES, IA 50320-2838
Phone number: 515-783-8297
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