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NPI Code Detail

MEDICARE: MRS. CATHERINE HOWLE JORDAN

MEDICARE: MRS. CATHERINE HOWLE JORDAN
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
1225XP0200XPediatric Occupational Therapist3972AL

General Provider Information

NPI Number : 1669863312
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE HOWLE JORDAN
Provider Business Mailing Address
First Line : 340 MENDEL PKWY W
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-5406
Country : US
Telephone Number : 334-532-0220
Fax Number :
Provider Business Practice Location Address
First Line : 340 MENDEL PKWY W
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-5406
Country : US
Telephone Number : 334-532-0220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2015
Last Update Date : 02/16/2015

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