Provider Demographics
NPI:1548003320
Name:BURNETT, JORDAN (DPT)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 HOPSON RD APT 1102
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8316
Mailing Address - Country:US
Mailing Address - Phone:928-848-7370
Mailing Address - Fax:
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 230
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5677
Practice Address - Country:US
Practice Address - Phone:919-660-5049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23250261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy