MEDICARE: JORDAN GREINER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	PT023808	PA
2	225100000X	Physical Therapist	PT023808	PA

General Provider Information

NPI Number	:	1346641685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN GREINER DPT

Provider Business Mailing Address
First Line	:	108 BITTERSWEET PATH
Second Line	:
City	:	WILLOW STREET
State	:	PA
Zip	:	17584-9658
Country	:	US
Telephone Number	:	717-808-8218
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 S SPORTING HILL RD FL 1
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-3059
Country	:	US
Telephone Number	:	717-512-8769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2014
Last Update Date	:	05/20/2026

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