JORDAN PAUL

CORONA, CA
NPI1710540034
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  R1333970119)
Enumeration Date2019-04-22
Last Update Date2019-04-22
Business Address
JORDAN PAUL RADT
623 N MAIN ST
CORONA, CA 92880-1407
Phone number: 909-488-9477
Mailing Address
JORDAN PAUL RADT
623 N MAIN ST
CORONA, CA 92880-1407
Phone number:
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