Provider Demographics
NPI:1881179893
Name:JORDAN, ALLISON (LMT, FDN-P)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LMT, FDN-P
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:39319 PLYMOUTH RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1059
Mailing Address - Country:US
Mailing Address - Phone:269-200-7530
Mailing Address - Fax:
Practice Address - Street 1:39319 PLYMOUTH RD STE 5
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1059
Practice Address - Country:US
Practice Address - Phone:734-417-3296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501010803225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist