JORDAN LICATA

TULLAHOMA, TN
NPI1952795106
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2015-03-26
Last Update Date2024-11-22
Business Address
JORDAN LICATA
1821 N WASHINGTON ST
TULLAHOMA, TN 37388-2221
Phone number: 931-461-5056
Mailing Address
JORDAN LICATA
1821 N WASHINGTON ST
TULLAHOMA, TN 37388-2221
Phone number: 931-461-5056
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