Individual
JORDAN R DENEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2300 53RD AVE STE LL02, BETTENDORF, IA 52722-7565
(563) 449-7000
Mailing address
850 43RD AVE STE 100, MOLINE, IL 61265-8401
(309) 743-2070
(309) 743-2073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070020563
IL
225100000X
Physical Therapist
Primary
072794
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072794
PT LICENSE
IA
Enumeration date
02/26/2014
Last updated
03/31/2021
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