Carl Richard Jordan, R.PH.

NPI #1356460752 in East Peoria, Illinois

Provider Information

NPI Number: 1356460752
Entity Type: Individual
Name: Carl Richard Jordan, R.PH.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: R.PH.
Enumeration Date: Mar 28, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 302 HARBOR POINTE DR
City: East Peoria
State: Illinois
ZIP Code: 61611-5802
Phone: (309) 698-1050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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