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Individual

HOLLY JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
129 COMMERCIAL DR UNIT 5B, YORKVILLE, IL 60560-4731
(630) 553-7737
(630) 553-7747
Mailing address
129 COMMERCIAL DR UNIT 5B, YORKVILLE, IL 60560-4731
(630) 553-7737
(630) 553-7747

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007427
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160007427
IL LICENSE
IL
Enumeration date
03/10/2016
Last updated
03/10/2016
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