| NPI | 1649772955 |
|---|---|
| Former Name | JORDAN RAE LOCKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL 12429) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2018000022) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2022-06-13 |