Individual
JORDAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
12360 MANCHESTER RD, DES PERES, MO 63131-4312
(314) 966-8855
Mailing address
12360 MANCHESTER RD, DES PERES, MO 63131-4312
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2016021914
MO
225100000X
Physical Therapist
2305210258
VA
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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