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NPI Code Detail

MEDICARE: JORDAN PERRY DPT

MEDICARE:   JORDAN  PERRY  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 Therapist42900CA

General Provider Information

NPI Number : 1326577966
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN PERRY DPT
Provider Business Mailing Address
First Line : 95 W CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91105-3026
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 95 W CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91105-3026
Country : US
Telephone Number : 626-304-0565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2017
Last Update Date : 06/07/2017

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Directions to “ JORDAN PERRY DPT” Practice Location

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