Joseph Edward Jordan
Individual provider Active NPI Physical Therapist · Pine Valley, UT
NPI 1629585369 · NPPES record last updated Jan 3, 2018
Key facts
- NPI
- 1629585369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 320 Pine Cone PL
Pine Valley, UT 84781-2375 - Phone
- (801) 821-9273
- NPI assigned
- Jan 3, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NM | Yes |
Addresses
Primary practice location
320 Pine Cone PL
Pine Valley, UT 84781-2375
Mailing address
320 Pine Cone PL
Pine Valley, UT 84781-2375
Other providers in Pine Valley, UT
All providers in Pine Valley, UT · Physical Therapist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.