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General NPI Number Information
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NPI Number | 1407720790
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Entity Type | Individual
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Provider Name | JORDAN MCINTYRE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1712 EYE ST NW
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City | WASHINGTON
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State | DC
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Zip | 20006-3702
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Country | US
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Telephone | 703-731-7917
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Fax |
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Provider Business Mailing Address
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Address Line | 6821 TIDDLE WAY
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City | LORTON
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State | VA
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Zip | 22079-1332
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Country | US
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Telephone |
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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 | PT210002590
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License Number State | DC
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