Freda Mae Diasanta Jordan, RPT

NPI #1053696476 in Silvis, Illinois

Provider Information

NPI Number: 1053696476
Entity Type: Individual
Name: Freda Mae Diasanta Jordan, RPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: RPT
Enumeration Date: Oct 17, 2011
Last Updated: Dec 5, 2014

Practice Location

Address: 1900 10TH ST
City: Silvis
State: Illinois
ZIP Code: 61282-1909
Phone: (309) 278-1537

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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