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Individual

LISA JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
6842 RACE TRACK RD, BOWIE, MD 20715-3011
(240) 544-0200
(301) 464-1053
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24299
MD
225100000X
Physical Therapist
J1-0002908
DE

Other

Enumeration date
11/15/2012
Last updated
03/07/2017
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