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Theodus Jordan, REVEREND
NPI 1700226321 · on the registry since 2013 · sole proprietor
Practice
- Address
- 804 Centre Street
300840 --Mailing
Jamaica Plain, MA 02130 - Phone
- (508) 588-6443
- Fax
- (508) 588-6443
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 101YP1600X
101YP2500X
101YP2500X - Licence states on file
- MA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-06-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts