Provider Demographics
NPI:1588306963
Name:HALE, JORDYN D (DC)
Entity type:Individual
Prefix:MISS
First Name:JORDYN
Middle Name:D
Last Name:HALE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-1531
Mailing Address - Country:US
Mailing Address - Phone:606-248-1388
Mailing Address - Fax:606-248-6890
Practice Address - Street 1:2403 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1531
Practice Address - Country:US
Practice Address - Phone:606-248-1388
Practice Address - Fax:606-248-6890
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY441922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor