JORDAN RUSSELL CARVER

LAFAYETTE, TN
NPI1912278391
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy314000000X Skilled Nursing Facility
(Licence: TN  1891)
Enumeration Date2012-01-18
Last Update Date2012-01-18
Business Address
Mr. JORDAN RUSSELL CARVER COTA/L
203 MAI RIDGE LANE
LAFAYETTE, TN 37083-4477
Phone number: 615-633-8159
Mailing Address
Mr. JORDAN RUSSELL CARVER COTA/L
203 MAI RIDGE LANE
LAFAYETTE, TN 37083-4477
Phone number: 615-633-8159
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