Individual
JORDAN CHASE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
325 W MORRIS BLVD STE B, MORRISTOWN, TN 37813-2237
(423) 317-7772
(423) 317-7773
Mailing address
325 W MORRIS BLVD, MORRISTOWN, TN 37813-2237
(423) 375-8907
(423) 317-7773
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11101
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11101
PT LICENSE
TN
05
—
Q027222
—
TN
05
—
Q038410
—
TN
Enumeration date
09/16/2016
Last updated
01/07/2026
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