Mr Avery Miles Jordan, LPTA/LPN | |
1201 E Broad Rock Rd, Rm 1s-112, Richmond, VA 23249-0001 | |
(804) 675-5000 | |
(804) 675-5335 |
Full Name | Mr Avery Miles Jordan |
---|---|
Gender | Male |
Speciality | Physical Therapy Assistant |
Location | 1201 E Broad Rock Rd, Richmond, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639362809 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164W00000X | Licensed Practical Nurse | 0002040749 (Virginia) | Secondary |
225200000X | Physical Therapy Assistant | 2306001152 (Virginia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr Avery Miles Jordan, LPTA/LPN 3708 Stamford Cir, Midlothian, VA 23112-3671 Ph: (804) 744-5303 | Mr Avery Miles Jordan, LPTA/LPN 1201 E Broad Rock Rd, Rm 1s-112, Richmond, VA 23249-0001 Ph: (804) 675-5000 |