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1346993573
JORDAN PORTNER
O FALLON, IL
NPI
1346993573
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: IL 242006237)
Enumeration Date
2022-01-28
Last Update Date
2022-02-09
Business Address
JORDAN PORTNER
634 N MAIN ST STE 3
O FALLON, IL 62269-3746
Phone number: 618-632-4222
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Mailing Address
JORDAN PORTNER
634 N MAIN ST STE 3
O FALLON, IL 62269-3746
Phone number: 618-632-4222
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