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1942959366
JORDAN GLEN MEMMOTT
GAINESVILLE, FL
NPI
1942959366
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-03-22
Last Update Date
2022-03-22
Business Address
JORDAN GLEN MEMMOTT DO
1147 NW 64TH TER
GAINESVILLE, FL 32605-4218
Phone number: 352-333-5168
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Mailing Address
JORDAN GLEN MEMMOTT DO
470 S 200 E
NEPHI, UT 84648-2110
Phone number: 435-660-6219
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