Healthcare Provider Details

I. General information

NPI: 1083522270
Provider Name (Legal Business Name): JORDAN HEKMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 GRANDIN RD SW
ROANOKE VA
24015-2305
US

IV. Provider business mailing address

729 TOWNSIDE RD SW APT 28
ROANOKE VA
24014-2223
US

V. Phone/Fax

Practice location:
  • Phone: 540-342-9525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217910
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: