Provider Demographics
NPI:1740960806
Name:LENOX, JORDAN SPENCER (DC)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:SPENCER
Last Name:LENOX
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 1:6723 HIGHLANDS CT
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0584
Mailing Address - Country:US
Mailing Address - Phone:903-400-9009
Mailing Address - Fax:
Practice Address - Street 1:6723 HIGHLANDS CT
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-0584
Practice Address - Country:US
Practice Address - Phone:903-400-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor