Basic Information
| Provider Information | |||||||||
| NPI: | 1386924066 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JORDAN PHYSICAL THERAPY CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2675 COURT DR | ||||||||
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| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280541478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048247800 | ||||||||
| FaxNumber: | 7048247898 | ||||||||
| Practice Location | |||||||||
| Address1: | 3903 N HIGHWAY 7 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS VILLAGE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719099604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016236011 | ||||||||
| FaxNumber: | 5016236611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2011 | ||||||||
| LastUpdateDate: | 08/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | LEIGHOW | ||||||||
| AuthorizedOfficialFirstName: | LEE ANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 7048247800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.