Individual
WYATT C JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
200 E IDAHO ST STE A, KALISPELL, MT 59901-4117
(406) 257-5610
(406) 257-1372
Mailing address
PO BOX 5718, KALISPELL, MT 59903-5718
(406) 756-0134
(406) 300-1612
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-LIC-21996
MT
Other
Enumeration date
08/31/2021
Last updated
12/01/2021
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