Individual
MR. DARRELL KEITH JORDAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
508 FULTON ST, DURHAM VAMC - PHYSICAL THERAPY DEPT, DURHAM, NC 27705-3875
(919) 286-0411
(919) 416-5913
Mailing address
427 CROWNE CREST DR, WINSTON SALEM, NC 27106-5071
(937) 902-7451
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.009570
OH
Other
Enumeration date
05/16/2006
Last updated
07/08/2007
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