Individual
JORDAN JONAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
200 IRISH RD, BERWYN, PA 19312-1260
(717) 945-9284
Mailing address
148 BROOKSHIRE DR, PHILADELPHIA, PA 19116-1204
(717) 945-9284
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RTO000325
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/22/2016
Last updated
01/06/2021
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