Provider Demographics
NPI:1164835559
Name:POND, JORDAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:M
Last Name:POND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2568 WATERBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3200
Mailing Address - Country:US
Mailing Address - Phone:812-401-1200
Mailing Address - Fax:
Practice Address - Street 1:2568 WATERBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3200
Practice Address - Country:US
Practice Address - Phone:812-401-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002756A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor