Individual
JORDAN HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4820 W NEWBERRY RD, GAINESVILLE, FL 32607-2249
(352) 373-2116
Mailing address
28808 NW 32ND AVE, NEWBERRY, FL 32669-2620
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTAT28304
FL
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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