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General NPI Number Information
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NPI Number | 1306556170
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Entity Type | Individual
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Provider Name | JORDAN HENDRICKS DPT
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Gender | Male
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 1060 EASTWIND DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-3331
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Country | US
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Telephone | 603-785-2583
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Fax |
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Provider Business Mailing Address
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Address Line | 3193 MILLBURY AVE
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City | DUBLIN
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State | OH
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Zip | 43017-1749
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Country | US
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Telephone | 603-785-2583
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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 | PT017351
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License Number State | OH
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