Individual
MR. JORDAN TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5800 FAIRFIELD AVE STE 150, FORT WAYNE, IN 46807-3450
(260) 744-5585
Mailing address
5800 FAIRFIELD AVE STE 150, FORT WAYNE, IN 46807-3450
(260) 744-5585
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012567A
IN
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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