Individual
CAROL A JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 347-2511
Mailing address
355 HIGHWAY 111, ALADDIN, WY 82710-9715
(307) 290-2447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0917
SD
225100000X
Physical Therapist
Primary
1498
NE
225100000X
Physical Therapist
PT-1225
WY
Other
Enumeration date
06/10/2006
Last updated
11/25/2014
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