Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHIRO08271 | GA |
NPI | 1295904894 |
---|---|
Provider Name | Ms. Jordan L Lunday |
First Address | Suwanee, GA 30024-2954 |
Second Address | Grayson, GA 30017-7851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2008 |
Last Update Date | 27/02/2008 |