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General NPI Number Information
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NPI Number | 1629671300
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Entity Type | Organization
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Legal Business Name | JORDAN CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 410 FLYNN ST
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City | ALVA
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State | OK
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Zip | 73717
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Country | US
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Telephone | 580-327-0032
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Fax | 580-327-0033
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Provider Business Mailing Address
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Address Line | 410 FLYNN ST
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City | ALVA
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State | OK
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Zip | 73717
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Country | US
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Telephone | 580-327-0032
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Fax | 580-327-0033
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Authorized Official
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Title or Position | OWNER
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Name | DR. TROY JOE JORDAN
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Credential | DC
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Telephone | 580-327-0032
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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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