Most Relevant Information
Provider Data
| NPI Number: | 1003426552 |
| Provider Name: | CHARLTON EDMOND JORDAN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/08/2020 |
| Last Updated: | 08/18/2020 |
Provider Practice Location
1290 CHAMBERS RD
AURORA
CO
800117117
Practice Location Phone/Fax
| Phone: | 3033643481 |
| Fax: |
Provider Mailing Location
1290 CHAMBERS RD
AURORA
CO
800117117
Provider Mailing Phone/Fax
| Phone: | 3033643481 |
| Fax: |