| Doctor Name: | MRS. MICHELLE RUTHANN JORDAN |
| NPI Number: | 1922128081 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 6155 |
| Business Practice Address: | 2971 Fort Henry Dr Kingsport, TN - 376644005 |
| Business Phone Number: | 4232308450 |
| Business Fax Number: | |
| Mailing Address: | 110 Robindale Ct, KINGSPORT |
| State: | TN |
| Postal Code: | 37663 |
| Phone Number: | 4237262083 |
| Fax Number: | |
| NPI Enumeration Date: | 03/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 6155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| 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 |