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1346414851
JERRY WALLACE JORDAN
STOCKTON, CA
NPI
1346414851
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2008-04-15
Last Update Date
2023-12-18
Business Address
JERRY WALLACE JORDAN
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8831
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Mailing Address
JERRY WALLACE JORDAN
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8831
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