DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JORDAN CHRSITIAN WILDER I

MEDICARE: JORDAN CHRSITIAN WILDER I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianSC

General Provider Information

NPI Number : 1568321560
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN CHRSITIAN WILDER I
Provider Business Mailing Address
First Line : 350 FAIRWAY DR STE 101
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 877-418-2978
Fax Number : 866-500-2186
Provider Business Practice Location Address
First Line : 1370 BROWNING RD STE 100
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-6939
Country : US
Telephone Number : 888-880-9270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

Similar Medicare Providers

1811855786 — ISABELLA REYNOLDS
Practice Location Address:
1370 BROWNING RD STE 100
COLUMBIA, SC
29210-6939
Practice Phone: 877-418-2978
Practice Fax:
1265391288 — DELANEY NICOLE FREEMAN
Practice Location Address:
1370 BROWNING RD STE 100
COLUMBIA, SC
29210-6939
Practice Phone: 877-418-2978
Practice Fax:
1770440380 — SAVANNAH FREEMAN
Practice Location Address:
1370 BROWNING RD STE 100
COLUMBIA, SC
29210-6939
Practice Phone: 888-880-9270
Practice Fax:
1043177678 — TAMIA ROBERTS
Practice Location Address:
1370 BROWNING RD STE 100
COLUMBIA, SC
29210-6939
Practice Phone: 877-418-2978
Practice Fax:
1407140387 — CRESCENT HOSPICE, INC.
Practice Location Address:
1370 BROWNING RD STE 110
COLUMBIA, SC
29210-6939
Practice Phone: 803-732-3274
Practice Fax: 803-732-4294
1609747492 — PAULA MAE A PECHO
Practice Location Address:
1370 BROWNING RD STE 100
COLUMBIA, SC
29210-6939
Practice Phone: 888-880-9270
Practice Fax:

Directions to “ JORDAN CHRSITIAN WILDER I ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.