Individual
JORDAN PHILIP WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2145 COUNTRY CLUB RD STE 200, JACKSONVILLE, NC 28546-2404
(252) 726-1802
(252) 726-1805
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(252) 726-1802
(252) 726-1805
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P20405
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P20405
PT LICENSE
NC
Enumeration date
05/14/2021
Last updated
01/15/2024
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