Provider Demographics
NPI:1841612223
Name:JORDO PHYSICAL THERAPY SERVICES
Entity Type:Organization
Organization Name:JORDO PHYSICAL THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:V
Authorized Official - Last Name:ORDONIO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:954-543-2819
Mailing Address - Street 1:17328 NEWLANDS CORNER LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2480
Mailing Address - Country:US
Mailing Address - Phone:954-643-2819
Mailing Address - Fax:
Practice Address - Street 1:17328 NEWLANDS CORNER LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2480
Practice Address - Country:US
Practice Address - Phone:954-643-2819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11561225100000X
NC11269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty