| NPI | 1437191160 |
|---|---|
| Former Name | CAROL A JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1498) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-1225) |
| 225100000X Physical Therapist (Licence: SD 0917) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2014-11-25 |