Provider Demographics
NPI:1205500675
Name:SWITZER, JORDAN ALYSSAA
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ALYSSAA
Last Name:SWITZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF NORTH ALABAMA
Mailing Address - Street 2:503-537 CIRCULAR RD
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:228-216-2118
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NORTH ALABAMA
Practice Address - Street 2:503-537 CIRCULAR RD
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:228-216-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25182255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer