Healthcare Provider Details

I. General information

NPI: 1770551871
Provider Name (Legal Business Name): PHYSICAL THERAPY CLINIC OF FRANKLIN,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL AVE
FRANKLIN LA
70538-3725
US

IV. Provider business mailing address

1600 HOSPITAL AVE
FRANKLIN LA
70538-3725
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 TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number037294R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY NEIL JORDAN
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: PT
Phone: 337-828-3600