Individual
JONATHAN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 JESSIE AVE, SACRAMENTO, CA 95838-2608
(916) 648-0143
Mailing address
501 JESSIE AVE, SACRAMENTO, CA 95838-2608
(916) 648-0143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA48399
CA
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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