Individual
CHASE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
317 W SPRING ST, COOKEVILLE, TN 38501-7102
(931) 526-9518
(931) 372-7717
Mailing address
105 S WILLOW AVE, COOKEVILLE, TN 38501-4667
(931) 526-9518
(931) 372-7717
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000011500
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q055326
—
TN
Enumeration date
12/20/2019
Last updated
10/10/2022
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