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1295100618
JORDAN COUGHLIN
OMAHA, NE
NPI
1295100618
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NE 1315)
Enumeration Date
2015-12-10
Last Update Date
2015-12-10
Business Address
-- JORDAN COUGHLIN PTA
17600 ARBOR ST
OMAHA, NE 68130-4682
Phone number: 402-717-0210
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Mailing Address
-- JORDAN COUGHLIN PTA
5875 GOLD ST
OMAHA, NE 68106-3020
Phone number:
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