Healthcare Provider Details

I. General information

NPI: 1740106517
Provider Name (Legal Business Name): JORDAN ELIZABETH DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ROCKLAND ST STE B
READING PA
19604-1501
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 610-816-6406
  • Fax: 610-816-6407
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: