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General NPI Number Information
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NPI Number | 1083248462
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Entity Type | Individual
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Provider Name | JORDAN NICOLE LINDON DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 520 GARDEN WAY
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City | EDGEWOOD
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-835-4373
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Fax |
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Provider Business Mailing Address
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Address Line | 520 GARDEN WAY
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City | EDGEWOOD
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State | KY
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Zip | 41017-3387
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Country | US
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Telephone | 859-835-4373
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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 | PTL0017143
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT007908
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | PT-007908
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License Number State | KY
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