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1770208837
KELLY JEAN JORDAN
CRESTWOOD, IL
NPI
1770208837
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: 057001853)
Enumeration Date
2022-10-11
Last Update Date
2022-10-11
Business Address
KELLY JEAN JORDAN
13020 S CENTRAL AVE
CRESTWOOD, IL 60418-2710
Phone number: 708-389-0555
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Mailing Address
KELLY JEAN JORDAN
9396 CALUMET ST
DYER, IN 46311-2778
Phone number: 708-539-3348
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