| Carol A Jordan, PT | |
|
113 Comanche Rd, Fort Meade, SD 57741-1002 | |
| (605) 347-2511 | |
| Not Available |
| Full Name | Carol A Jordan |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 113 Comanche Rd, Fort Meade, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437191160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT-1225 (Wyoming) | Secondary |
| 225100000X | Physical Therapist | 1498 (Nebraska) | Primary |
| 225100000X | Physical Therapist | 0917 (South Dakota) | Secondary |
| Provider Name | William H And Carrie Gottsche Foundation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558319392 PECOS PAC ID: 5092606293 Enrollment ID: O20040324001113 |
| Mailing Address | Practice Location Address |
|---|---|
| Carol A Jordan, PT 355 Highway 111, Aladdin, WY 82710-9715 Ph: (307) 290-2447 | Carol A Jordan, PT 113 Comanche Rd, Fort Meade, SD 57741-1002 Ph: (605) 347-2511 |
Christina Arrechavala, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Comanche Rd, Fort Meade, SD 57741 Phone: 605-347-2511 | |
Catherine Mary Duffy, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Comanche Rd, Fort Meade, SD 57741 Phone: 605-720-7118 | |
Cade Kling, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Comanche Rd, Fort Meade, SD 57741 Phone: 605-347-2511 | |
Kimberley Crosswait, PTMS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Comanche Rd, Fort Meade, SD 57741 Phone: 800-743-1070 Fax: 605-720-7332 | |
Michelle Grinager, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Comanche Rd, Fort Meade, SD 57741 Phone: 605-720-7358 | |
Derrik Ehlers, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Comanche Rd, Fort Meade, SD 57741 Phone: 053-472-5116 |