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General NPI Number Information
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NPI Number | 1235788894
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Entity Type | Individual
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Provider Name | JORDAN BLAIRE RIGNEY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 28 JIMMY DOOLITTLE DR
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City | GREENVILLE
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State | SC
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Zip | 29607-2622
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Country | US
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Telephone | 864-679-8606
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Fax | 864-679-8608
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Provider Business Mailing Address
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Address Line | 3434 LAURENS RD APT 517
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City | GREENVILLE
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State | SC
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Zip | 29607-5281
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Country | US
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Telephone | 304-550-8804
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5637
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License Number State | SC
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