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Organization
JORDAN PHYSICAL THERAPY CENTER INC
Active
Organization
JORDAN PHYSICAL THERAPY CENTER INC
Active
Other names
Jordan LaSalle Physical Therapy Center Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY JORDAN MPT (OWNER)
(760) 568-2894
Entity
Organization
Contact information
Practice address
42080 STATE STREET, PALM DESERT, CA 92211-5173
(760) 568-2894
(760) 568-2894
Mailing address
42080 STATE STREET, PALM DESERT, CA 92211-5173
(760) 568-2894
(760) 346-4179
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
693682
ACN
—
01
—
DE9702
PALMETTO GBA
—
01
—
ZZZ64862Z
BLUE SHIELD OF CA
CA
Enumeration date
10/18/2006
Last updated
04/20/2008
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