Provider Demographics
NPI:1710870795
Name:STREETER, JORDON (LABORATORY DIRECTOR)
Entity type:Individual
Prefix:
First Name:JORDON
Middle Name:
Last Name:STREETER
Suffix:
Gender:F
Credentials:LABORATORY DIRECTOR
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3420 ATRIUM BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5186
Mailing Address - Country:US
Mailing Address - Phone:844-446-9455
Mailing Address - Fax:
Practice Address - Street 1:3420 ATRIUM BLVD STE 160
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-5186
Practice Address - Country:US
Practice Address - Phone:844-446-9455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy