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General NPI Number Information
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NPI Number | 1003635889
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Entity Type | Individual
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Provider Name | SCOTT J JORDAN DPT
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Gender | Male
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 187 COUNTY ROAD 519
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City | BELVIDERE
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State | NJ
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Zip | 07823-1900
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Country | US
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Telephone | 908-847-3390
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Fax |
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Provider Business Mailing Address
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Address Line | 17 UNION RD
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City | CLINTON
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State | NJ
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Zip | 08809-1229
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Country | US
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Telephone | 908-894-8105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA02289500
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License Number State | NJ
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