Provider Demographics
NPI:1841728813
Name:PRITCHARD, JORDAN LYN (DPT)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LYN
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:LYN
Other - Last Name:OVERLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2707 STANGE RD
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3965
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010
Practice Address - Country:US
Practice Address - Phone:515-239-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IA087866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist