| NPI | 1780816850 |
|---|---|
| Former Name | JORDAN NICOLE BIRKHEAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 26502) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: FL AL2597) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2017-12-20 |