Individual
JORDAN J MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, OCS
Contact information
Practice address
1400 MADISON AVE STE 100AA, MANKATO, MN 56001-5465
(507) 385-2600
Mailing address
1400 MADISON AVE STE 100AA, MANKATO, MN 56001-5465
(507) 385-2600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8819
MN
Other
Enumeration date
11/10/2011
Last updated
02/03/2021
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