Doctor Name: | DR. JORDAN MICHELLE TUCKER |
NPI Number: | 1376669853 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT DPT |
License Number: | 21723 |
Business Practice Address: | 3750 Joseph Siewick Dr Fairfax, VA - 220331742 |
Business Phone Number: | 7033911026 |
Business Fax Number: | |
Mailing Address: | 3750 Joseph Siewick Dr, FAIRFAX |
State: | VA |
Postal Code: | 220331742 |
Phone Number: | 7033911026 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2007 |
NPI Last Update Date: | 02/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 21723 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
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 |