Most Relevant Information
Provider Data
| NPI Number: | 1003494915 |
| Provider Name: | WILLIAM JORDAN HERRIN |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/31/2021 |
| Last Updated: | 03/31/2021 |
Provider Practice Location
6965 WATERS EDGE DR
STONE MOUNTAIN
GA
300875455
Practice Location Phone/Fax
| Phone: | 6784884056 |
| Fax: |
Provider Mailing Location
6965 WATERS EDGE DR
STONE MOUNTAIN
GA
300875455
Provider Mailing Phone/Fax
| Phone: | 6784884056 |
| Fax: |