Freda Mae Diasanta Jordan RPT

NPI 1053696476 - Physical Therapist - 225100000X

NPI Details
NPI 1053696476
Gender Female
Enumeration Date 10/17/2011
Last Updated 12/05/2014
Entity Type Individual
Active Over 5 years ago
Practice Location
1900 10TH ST
SILVIS IL, 61282-1909, US
Phone (309) 278-1537
Fax
Business Location
10500 WAYZATA BLVD
HOPKINS MN, 55305-1511, US
Phone (952) 224-1919
Fax
Toxanomy
Taxonomy Code 225100000X
License State New York
License Number 032857
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According to our database, Freda Mae Diasanta Jordan RPT NPI is 1053696476, taxonomy code is 225100000X and license number is 032857, license state is located at New York. Freda Mae Diasanta Jordan RPT physically located at 1900 10th St, Silvis IL, 61282-1909. NPI Number Freda Mae Diasanta Jordan RPT has the Individual type.

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1053696476 NPI number is provided on an as is basis without warranty of any kind. 1053696476 is maintained by the National Plan & Provider Enumeration System. The contents of Freda Mae Diasanta Jordan RPT are for informational purposes only.