# AIKEN PHYSICAL MEDICINE AND REHABILITATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912240383
- **Authorized official:** DR. PHILIP R JORDAN D.C. (OWNER/CHIROPRACTOR)
- **Authorized official phone:** (803) 226-0217

## Contact information

- **Practice address:** 2741 WHISKEY RD, AIKEN, SC 29803-6197
- **Practice address phone:** (803) 226-0217
- **Practice address fax:** (803) 226-0459
- **Mailing address:** 2741 WHISKEY RD, AIKEN, SC 29803-6197
- **Mailing address phone:** (803) 226-0217
- **Mailing address fax:** (803) 226-0459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3663 | SC | — |
| 163WW0101X | Ambulatory Women's Health Care Registered Nurse | 17794 | SC | — |
| 207QA0505X | Adult Medicine Physician | 000695 | SC | Yes |

## Other

- **Enumeration date:** 04/03/2013
- **Last updated:** 05/03/2013