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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JORDAN BENNETT

Active

Physical Therapy Assistant · GULFPORT, MS

Registration Details

NPI Number
1194131870
Provider Type
Individual
Gender
Male
NPI Issued
Jul 2, 2014 (11.803717040387 yrs)
Last Updated
Aug 22, 2023
License
PT5517 (MS)

Practice Information

Address
11010 DAVID ST STE A
GULFPORT, MS, 395033481
Browse MS providers · Browse ZIP 39503
Phone
2288328327
Primary Specialty
Physical Therapy Assistant
225100000X

Other Physical Therapy Assistant Providers in GULFPORT, MS

Name Credential NPI
CYNTHIA B. SHIELDS PT 1528094380
LINDA MARIE CHAVERS PT 1780616185
JOSEPH FRAME PT 1396858841
KENNETH JOHN ACKERMAN 1992812135
SUZANNE ELIZABETH RUCKER PT 1235246489
TIMOTHY JOSEPH KRUCHOWSKY PT 1083722284
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.