MEDICARE: DR. JORDAN LABREC PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT300286	CA
2	225100000X	Physical Therapist	25127	MA

General Provider Information

NPI Number	:	1194338962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN LABREC PT

Provider Business Mailing Address
First Line	:	266 E BERKELEY ST APT 646
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02118-2954
Country	:	US
Telephone Number	:	360-791-5750
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 CALIFORNIA DR
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-4145
Country	:	US
Telephone Number	:	650-341-9131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2020
Last Update Date	:	08/06/2025

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Directions to “ DR. JORDAN LABREC PT” Practice Location

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