Domenick, Jordan

Domenick, Jordan is an sole proprietor health care provider with primary practice located at 1061 Harmon Ave , Fort Stewart GA 31314-5641. He recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as his primary health care specialty. Domenick, Jordan can be contacted via phone (912) 435-6633.

Contact Information

Primary practice address
1061 Harmon Ave Fort Stewart GA 31314-5641
Phone: (912) 435-6633
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 4237 Minnesota
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 2022036290 Missouri

Profile Details

NPI number 1053988477
LBN Legal business name Domenick, Jordan
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 4th, 2021
Last updated Dec 28th, 2023 - about 2 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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