Most Relevant Information
Provider Data
| NPI Number: | 1003373085 |
| Provider Name: | JORDAN NICOLE MCCOWEN DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 2018029942 |
Most Important Dates
| Enumeration Date: | 02/26/2019 |
| Last Updated: | 02/26/2019 |
Provider Practice Location
2 HARBOR BEND CT STE 102
LAKE SAINT LOUIS
MO
633671480
Practice Location Phone/Fax
| Phone: | 6362952070 |
| Fax: |
Provider Mailing Location
2 HARBOR BEND CT STE 102
LAKE SAINT LOUIS
MO
633671480
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |