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General NPI Number Information
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NPI Number | 1104234483
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Entity Type | Individual
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Provider Name | JORDAN N DAVIS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 20117 FRANKLIN CIR STE 100
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City | ELKHORN
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State | NE
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Zip | 68022-6578
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Country | US
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Telephone | 402-431-2026
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Fax | 531-201-0301
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Provider Business Mailing Address
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Address Line | 7327 N 166TH ST
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City | BENNINGTON
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State | NE
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Zip | 68007-2833
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Country | US
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Telephone | 402-431-2026
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Fax | 531-201-0301
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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 | 3363
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License Number State | NE
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