Individual
MICHAEL K JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1308 MARTHA CUSTIS DR, ALEXANDRIA, VA 22302-2025
(574) 360-4996
Mailing address
1308 MARTHA CUSTIS DR, ALEXANDRIA, VA 22302-2025
(574) 360-4996
(630) 575-7450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070022222
IL
2251S0007X
Sports Physical Therapist
Primary
2305211549
VA
Other
Enumeration date
07/10/2017
Last updated
12/02/2020
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