Provider Demographics
NPI:1598302861
Name:JORDAN, JAMES B (RCEP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:JORDAN
Suffix:
Gender:M
Credentials:RCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 WASHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2417
Mailing Address - Country:US
Mailing Address - Phone:615-838-5352
Mailing Address - Fax:
Practice Address - Street 1:717 WASHINGTON DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2417
Practice Address - Country:US
Practice Address - Phone:615-838-5352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist