Doctor Name: | JORDAN ADAM SHETTLE |
NPI Number: | 1699030262 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | PT022045 |
Business Practice Address: | 1401 Pulaski Hwy Ste F Edgewood, MD - 210401398 |
Business Phone Number: | 4433725300 |
Business Fax Number: | 4433725810 |
Mailing Address: | 1401 Pulaski Hwy Ste F, EDGEWOOD |
State: | MD |
Postal Code: | 210401398 |
Phone Number: | 4433725300 |
Fax Number: | 4433725810 |
NPI Enumeration Date: | 07/10/2012 |
NPI Last Update Date: | 01/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT022045 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
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 |