Provider Demographics
NPI:1578941605
Name:JORDING, AMALIA
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:JORDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W55N182 WOODMERE CT
Mailing Address - Street 2:APT 3
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2836
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:W55N182 WOODMERE CT
Practice Address - Street 2:APT 3
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2836
Practice Address - Country:US
Practice Address - Phone:815-383-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer