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NPI Code Detail

MEDICARE: JORDAN LORMOR LPTA

MEDICARE: JORDAN LORMOR LPTA
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 Therapist1398569TX
2225200000XPhysical Therapy Assistant2156700TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11398569OTHERTXPHYSICAL THERAPIST
22156700OTHERTXLICENSED PHYSICAL THERAPIST ASSISTANT

General Provider Information

NPI Number : 1528660800
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN LORMOR LPTA
Provider Business Mailing Address
First Line : 1620 RINGTAIL DR
Second Line :
City : WYLIE
State : TX
Zip : 75098-6696
Country : US
Telephone Number : 469-879-2195
Fax Number :
Provider Business Practice Location Address
First Line : 185 CORNERSTONE LN
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6500
Country : US
Telephone Number : 501-525-4855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2020
Last Update Date : 10/09/2024

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