Individual
DR. JENNIFER JORDAN LANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P. T.
Contact information
Practice address
163 WINDING WAY, PEMBROKE, GA 31321-5535
(912) 547-0181
(912) 653-7979
Mailing address
PO BOX 39, PEMBROKE, GA 31321-0039
(912) 653-4863
(912) 653-7979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4288
GA
2251N0400X
Neurology Physical Therapist
4288
GA
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000859075A
—
GA
Enumeration date
05/24/2006
Last updated
02/24/2010
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