Provider Demographics
NPI:1477378099
Name:CASE, JORDAN HARDING
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:HARDING
Last Name:CASE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 OLD SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-1237
Mailing Address - Country:US
Mailing Address - Phone:937-971-0390
Mailing Address - Fax:
Practice Address - Street 1:1049 OLD SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1237
Practice Address - Country:US
Practice Address - Phone:937-971-0390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider