Individual provider · NPI-1

Dr. Jordan Alexander Baca, PT, DPT

Physical Therapist · Charleston, SC

NPI number1831446228
StatusActive
Last updated in NPPESSep 30, 2019

Details

NPI
1831446228
Entity type
Individual (NPI-1)
Name
Dr. Jordan Alexander Baca
Credential
PT, DPT
Sex
Male
Sole proprietor
No
Enumeration date
Aug 6, 2012
Last updated
Sep 30, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist6772SCYes

Practice location

915 Folly Rd Ste J
Charleston, SC 29412-3907

Phone 843-203-6955 · Fax 843-805-4908

Mailing address

800 Crescent Centre Dr Ste 300
Franklin, TN 37067-7285

Phone 615-373-1350 · Fax 615-221-9054

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