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1902315203
DE ANDRE JORDAN
CULVER CITY, CA
NPI
1902315203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2017-09-29
Last Update Date
2022-07-21
Business Address
DE ANDRE JORDAN
9808 VENICE BLVD STE 505
CULVER CITY, CA 90232-6818
Phone number: 310-237-0461
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Mailing Address
DE ANDRE JORDAN
9808 VENICE BLVD STE 505
CULVER CITY, CA 90232-6818
Phone number: 310-237-0461
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