Individual
JORDAN ELAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12216 W BROAD ST STE 4B-5, HENRICO, VA 23233-1062
(804) 533-0071
(804) 200-7124
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 968-1803
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305216529
VA
Other
Enumeration date
06/06/2024
Last updated
06/12/2024
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