Individual
MRS. JORDAN KAIT EAGLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
4851 TINCHER RD, INDIANAPOLIS, IN 46221-3780
(317) 856-4851
Mailing address
10755 GLENAYR DR, CAMBY, IN 46113-8908
(618) 204-9405
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006029A
IN
Other
Enumeration date
08/18/2021
Last updated
06/04/2024
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