Individual
TINA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
307 MAIN ST, LANDER, WY 82520-3101
(307) 332-2715
(307) 332-3014
Mailing address
307 MAIN ST, LANDER, WY 82520-3101
(307) 332-2715
(307) 332-3014
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
COTA-733
WY
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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