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General NPI Number Information
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NPI Number | 1780816850
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Entity Type | Individual
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Provider Name | JORDAN BIRKHEAD CUENIN PT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 3611 HIGHWAY 153
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City | GREENVILLE
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State | SC
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Zip | 29611-7516
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Country | US
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Telephone | 864-210-9625
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 HIGHWAY 153
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City | GREENVILLE
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State | SC
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Zip | 29611-7516
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Country | US
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Telephone | 864-210-9625
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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 | PT8078
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License Number State | SC
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