Individual
MR. JORDAN ZUCCARELLI
Active
Individual
MR. JORDAN ZUCCARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04804
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201101340A
—
KS
Enumeration date
06/11/2014
Last updated
10/11/2021
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