Individual
JODY MICHAEL JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
425 WESTMINSTER AVE, HANOVER, PA 17331-9141
(717) 637-4166
Mailing address
9 ELK DR, HANOVER, PA 17331-8869
(443) 974-8831
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OP010023
PA
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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