Individual
JORDAN WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
940 W HUMBOLDT ST APT 19, BATTLE MOUNTAIN, NV 89820
(775) 374-1659
Mailing address
1444 FALLS AVE E, TWIN FALLS, ID 83301-3408
(775) 374-1659
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3731
NV
225100000X
Physical Therapist
Primary
PT-6376
ID
Other
Enumeration date
07/31/2018
Last updated
04/27/2019
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