Provider Demographics
NPI:1477802478
Name:JORDAN, LINDSEY ANN (PT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:JORDAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:AN
Other - Last Name:FAIRCHILD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9116 W BOWLES AVE
Mailing Address - Street 2:STE 10
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-8611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9116 W BOWLES AVE
Practice Address - Street 2:STE 10
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8611
Practice Address - Country:US
Practice Address - Phone:130-397-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist