Healthcare Provider Details

I. General information

NPI: 1609798735
Provider Name (Legal Business Name): JORDAN DENMARK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 AIRPORT BLVD STE 100
MOBILE AL
36608-3142
US

IV. Provider business mailing address

6001 AIRPORT BLVD STE 100
MOBILE AL
36608-3142
US

V. Phone/Fax

Practice location:
  • Phone: 251-329-1449
  • Fax: 251-206-0887
Mailing address:
  • Phone: 251-329-1449
  • Fax: 251-206-0887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7034
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: