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Individual
BRADLEY DEAN JORDAN
Active
Individual
BRADLEY DEAN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR CHT
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
915917
NULL
2251X0800X
Orthopedic Physical Therapist
915917
NULL
225X00000X
Occupational Therapist
915917
NULL
Other
Enumeration date
11/18/2005
Last updated
09/11/2025
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