| Doctor Name: | MR. JEDD ALAN THORDERSON |
| NPI Number: | 1972790822 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT4029 |
| Business Practice Address: | 3437 Tupelo Commons Suite 102 Tupelo, MS - 388049791 |
| Business Phone Number: | 6626803200 |
| Business Fax Number: | 6626805090 |
| Mailing Address: | Po Box 44, 206 B Oxford Road NEW ALBANY |
| State: | MS |
| Postal Code: | 386520044 |
| Phone Number: | 6625344445 |
| Fax Number: | 6625349449 |
| NPI Enumeration Date: | 09/25/2007 |
| NPI Last Update Date: | 03/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT4029 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| 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 |