Individual
LISA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
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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