Provider Demographics
NPI:1770672107
Name:JORDANO, SALVATORE V (DC)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:V
Last Name:JORDANO
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 1:172 E MERRITT ST
Mailing Address - Street 2:STE. B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2026
Mailing Address - Country:US
Mailing Address - Phone:928-445-5818
Mailing Address - Fax:928-445-3144
Practice Address - Street 1:172 E MERRITT ST
Practice Address - Street 2:STE. B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2026
Practice Address - Country:US
Practice Address - Phone:928-445-5818
Practice Address - Fax:928-445-3144
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZDC3792AMedicare PIN
U18553Medicare UPIN