Provider Demographics
NPI:1750834321
Name:KEENE, JORDAN LINDSEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:LINDSEY
Last Name:KEENE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:LINDSEY
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:9411 ERIS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-4505
Mailing Address - Country:US
Mailing Address - Phone:817-937-7389
Mailing Address - Fax:
Practice Address - Street 1:1917 ABBOTT RD STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3449
Practice Address - Country:US
Practice Address - Phone:907-279-4266
Practice Address - Fax:907-279-4272
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK214152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist