| NPI | 1154798387 |
|---|---|
| Former Name | JORDAN COLLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: WA PT61170245) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1262522) |
| 225100000X Physical Therapist (Licence: WA PT61190627) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2024-05-21 |