Individual
JORDAN TANAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, CSRS
Contact information
Practice address
9330 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9104
(843) 797-7000
Mailing address
206 COUNTRY CLUB BLVD, SUMMERVILLE, SC 29483-3508
(240) 577-8351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13103
SC
Other
Enumeration date
12/22/2023
Last updated
11/04/2025
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