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1093483406
WYATT C JORDAN
KALISPELL, MT
NPI
1093483406
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MT PTP-PT-LIC-21996)
Enumeration Date
2021-08-31
Last Update Date
2021-12-01
Business Address
WYATT C JORDAN DPT
200 E IDAHO ST STE A
KALISPELL, MT 59901-4117
Phone number: 406-257-5610
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Mailing Address
WYATT C JORDAN DPT
PO BOX 5718
KALISPELL, MT 59903-5718
Phone number: 406-756-0134
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