Most Relevant Information
Provider Data
| NPI Number: | 1003569708 |
| Provider Name: | RENEE JORDAN |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 133071 |
Most Important Dates
| Enumeration Date: | 02/02/2022 |
| Last Updated: | 02/02/2022 |
Provider Practice Location
333 DOMINION DR
KATY
TX
774502076
Practice Location Phone/Fax
| Phone: | 5623314920 |
| Fax: |
Provider Mailing Location
333 DOMINION DR
KATY
TX
774502076
Provider Mailing Phone/Fax
| Phone: | 5623314920 |
| Fax: |