| NPI | 1649225624 |
|---|---|
| Former Name | JENNIFER LEE JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: GA 4288) |
| 225100000X Physical Therapist (Licence: GA 4288) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2010-02-24 |