Provider Demographics
NPI:1205686359
Name:OLKO, JORDAN MARIE
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:MARIE
Last Name:OLKO
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 1:1924 KING RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-8313
Mailing Address - Country:US
Mailing Address - Phone:810-441-3457
Mailing Address - Fax:
Practice Address - Street 1:1200 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48859-2001
Practice Address - Country:US
Practice Address - Phone:989-774-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer