Individual
MICHELLE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPY ASS
Contact information
Practice address
1676 SUNSET AVE, UTICA, NY 13502-5416
(315) 624-5400
(315) 624-5395
Mailing address
2209 GENESEE STREET, BUSINESS OFFICE ROOM 315, UTICA, NY 13501
(315) 801-3282
(315) 801-8391
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
009541
NY
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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