Individual
SADIE RAE JORDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1208
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5834000
—
SD
01
—
PT1208
DAKOTA CARE
SD
Enumeration date
03/26/2007
Last updated
07/08/2007
Update your record
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