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General NPI Number Information
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NPI Number | 1407929466
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Entity Type | Organization
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Legal Business Name | LUCINDA JORDAN, DC, PC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 10/08/2007
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Provider Practice Location Address
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Address Line | 3901 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5538
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Country | US
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Telephone | 812-334-0082
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Fax | 812-334-1019
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Provider Business Mailing Address
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Address Line | 3901 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5538
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Country | US
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Telephone | 812-334-0082
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Fax | 812-334-1019
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Authorized Official
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Title or Position | OWNER
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Name | LUCINDA JORDAN
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Credential | D.C.
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Telephone | 812-334-0082
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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 |
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License Number State |
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