Provider Demographics
NPI:1770551871
Name:PHYSICAL THERAPY CLINIC OF FRANKLIN,
Entity type:Organization
Organization Name:PHYSICAL THERAPY CLINIC OF FRANKLIN,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:337-828-3600
Mailing Address - Street 1:1600 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-3725
Mailing Address - Country:US
Mailing Address - Phone:337-828-3600
Mailing Address - Fax:337-828-4557
Practice Address - Street 1:1600 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-3725
Practice Address - Country:US
Practice Address - Phone:337-828-3600
Practice Address - Fax:337-828-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA037294R261QP2000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CC66Medicare ID - Type UnspecifiedMEDICARE NUMBER