Healthcare Provider Details

I. General information

NPI: 1578784195
Provider Name (Legal Business Name): JEFFREY NEIL JORDAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL AVENUE
FRANKLIN LA
70538
US

IV. Provider business mailing address

1600 HOSPITAL AVENUE
FRANKLIN LA
70538
US

V. Phone/Fax

Practice location:
  • Phone: 337-828-3600
  • Fax: 337-828-4557
Mailing address:
  • Phone: 337-828-3600
  • Fax: 337-828-4557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: