| NPI | 1659813012 |
|---|---|
| Former Name | JORDAN LEEANN ISOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA PT43184) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA PT43184) |
| 273Y00000X Rehabilitation Unit (Licence: CA 43184) | |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2020-11-20 |