Individual
MR. JEDD ALAN THORDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4340 KINGS WAY, VALDOSTA, GA 31602-6921
(229) 333-9736
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT007933
GA
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
PT007933
GA
Other
Enumeration date
09/25/2007
Last updated
01/08/2025
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