Individual
IVY L JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
736 BROADWAY N, FARGO, ND 58102
(701) 234-2000
Mailing address
3155 BLUESTEM DR, WEST FARGO, ND 58078-8002
(701) 353-5476
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11224
MN
225100000X
Physical Therapist
Primary
2065
ND
225100000X
Physical Therapist
2305206961
VA
225100000X
Physical Therapist
PT871270
DC
Other
Enumeration date
11/30/2011
Last updated
08/19/2018
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