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General NPI Number Information
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NPI Number | 1013493501
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Entity Type | Individual
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Provider Name | CHRISTOPHER ROBERT JORDAN DC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 1254 SE CENTURY DR
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City | LEES SUMMIT
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State | MO
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Zip | 64081-3286
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Country | US
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Telephone | 816-988-0058
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Fax | 816-988-3031
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Provider Business Mailing Address
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Address Line | 1011 BELLFLOWER LN
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City | GREENWOOD
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State | MO
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Zip | 64034-7808
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Country | US
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Telephone | 816-808-6873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2018020088
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License Number State | MO
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