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1922370543
JORDAN WILLIAM WILDE
GRESHAM, OR
NPI
1922370543
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
111N00000X Chiropractor
(Licence: OR 5033)
Enumeration Date
2012-01-27
Last Update Date
2020-10-13
Business Address
Dr. JORDAN WILLIAM WILDE D.C.
191 SE STARK STREET
GRESHAM, OR 97233-8386
Phone number: 503-328-9300
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Mailing Address
Dr. JORDAN WILLIAM WILDE D.C.
15777 SE RUBY DR
MILWAUKIE, OR 97267-3703
Phone number:
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