Individual
ANTHONY EUGENE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
52115 PROSECCO WAY, COACHELLA, CA 92236-8511
(760) 777-2140
Mailing address
52115 PROSECCO WAY, COACHELLA, CA 92236-8511
(760) 777-2140
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
3854
CA
2251G0304X
Geriatric Physical Therapist
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Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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