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NPI Code Detail

MEDICARE: JORDAN HENDRICKS DPT

MEDICARE: JORDAN HENDRICKS DPT
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
1225100000XPhysical TherapistPT017351OH

General Provider Information

NPI Number : 1306556170
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN HENDRICKS DPT
Provider Business Mailing Address
First Line : 3193 MILLBURY AVE
Second Line :
City : DUBLIN
State : OH
Zip : 43017-1749
Country : US
Telephone Number : 603-785-2583
Fax Number :
Provider Business Practice Location Address
First Line : 1060 EASTWIND DR
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-3331
Country : US
Telephone Number : 603-785-2583
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2022
Last Update Date : 12/01/2022

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Directions to “ JORDAN HENDRICKS DPT” Practice Location

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