Individual
JEREMY JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1701 LEGACY DR STE 1475, FRISCO, TX 75034-2064
(877) 896-3660
Mailing address
404 VALLEY COVE DR, RICHARDSON, TX 75080-1843
(512) 586-4583
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
111246
TX
Other
Enumeration date
05/14/2007
Last updated
09/09/2011
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