| Doctor Name: | JORDAN THERESA BRYDE |
| NPI Number: | 1023483526 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 5501017278 |
| Business Practice Address: | 1415 S Main St Ste B Eaton Rapids, MI - 488271959 |
| Business Phone Number: | 5177814999 |
| Business Fax Number: | 5176632506 |
| Mailing Address: | 625 Enterprise Dr, OAK BROOK |
| State: | IL |
| Postal Code: | 605238813 |
| Phone Number: | 6305751980 |
| Fax Number: | 6309285080 |
| NPI Enumeration Date: | 12/09/2015 |
| NPI Last Update Date: | 12/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501017278 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |