Provider Demographics
NPI:1013493501
Name:JORDAN, CHRISTOPHER ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:JORDAN
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 1:1011 BELLFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-7808
Mailing Address - Country:US
Mailing Address - Phone:816-808-6873
Mailing Address - Fax:
Practice Address - Street 1:1254 SE CENTURY DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-3286
Practice Address - Country:US
Practice Address - Phone:816-988-0058
Practice Address - Fax:816-988-3031
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018020088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor