Provider Demographics
NPI:1275049645
Name:CLINE, JORDAN HOAG (DC)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:HOAG
Last Name:CLINE
Suffix:
Gender:F
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:PO BOX 671942
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30006-0033
Mailing Address - Country:US
Mailing Address - Phone:770-545-2550
Mailing Address - Fax:
Practice Address - Street 1:2551 ROSWELL RD STE 420
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-4761
Practice Address - Country:US
Practice Address - Phone:770-545-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor