Provider Demographics
NPI:1831611664
Name:PRESS, JORDAN ZACHARY (AUD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:ZACHARY
Last Name:PRESS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 W 136TH PL APT 104
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-7308
Mailing Address - Country:US
Mailing Address - Phone:913-890-3925
Mailing Address - Fax:
Practice Address - Street 1:107 N PINE ST STE 3
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-4743
Practice Address - Country:US
Practice Address - Phone:620-232-7500
Practice Address - Fax:620-232-7501
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2320231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist