Individual
JORDAN PRINDIVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1214 E NATIONAL AVE STE 100B, BRAZIL, IN 47834-2747
(812) 442-2635
Mailing address
68 S 21ST ST APT B, TERRE HAUTE, IN 47803-1820
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05014762A
IN
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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