Blake, Jordan

Blake, Jordan is an sole proprietor health care provider with primary practice located at 1700 Lakeside Dr , Garner NC 27529-3845. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Blake, Jordan can be contacted via phone (919) 612-5856.

Contact Information

Primary practice address
1700 Lakeside Dr Garner NC 27529-3845
Phone: (919) 612-5856
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1467840645
LBN Legal business name Blake, Jordan
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 22nd, 2014
Last updated Dec 23rd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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