Individual
JORDAN COUGHLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
17600 ARBOR ST, OMAHA, NE 68130-4682
(402) 717-0210
Mailing address
5875 GOLD ST, OMAHA, NE 68106-3020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1315
NE
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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