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1932118296
MANLEY MCRAE JORDAN
LAKE CHARLES, LA
NPI
1932118296
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RP1001X Internal Medicine, Pulmonary Disease
(Licence: LA 017837)
Enumeration Date
2006-08-05
Last Update Date
2015-12-02
Business Address
-- MANLEY MCRAE JORDAN MD
2770 3RD AVE SUITE 110
LAKE CHARLES, LA 70601-8994
Phone number: 337-494-2750
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Mailing Address
-- MANLEY MCRAE JORDAN MD
PO BOX 122309 DEPT 2309
DALLAS, TX 75312-2309
Phone number: 337-494-2919
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