Individual
JORDAN HENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1423 W CENTRE AVE, PORTAGE, MI 49024-5323
(269) 323-4300
Mailing address
1423 W CENTRE AVE, PORTAGE, MI 49024-5323
(269) 323-4300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501019285
MI
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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