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General NPI Number Information
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NPI Number | 1619860038
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Entity Type | Individual
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Provider Name | JORDYN MINDA
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Gender | Female
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 3540 WASHINGTON RD
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City | CANONSBURG
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State | PA
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Zip | 15317-2957
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Country | US
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Telephone | 412-367-2156
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Fax | 724-941-7772
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Provider Business Mailing Address
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Address Line | 3540 WASHINGTON RD
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City | CANONSBURG
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State | PA
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Zip | 15317-2957
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Country | US
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Telephone | 412-367-2156
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Fax | 724-941-7772
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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 | PT033047
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License Number State | PA
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