Provider Demographics
NPI:1902336860
Name:MCSWEENEY, JORDAN JAMES (DPT)
Entity type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:JAMES
Last Name:MCSWEENEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NE TUDOR RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5601
Mailing Address - Country:US
Mailing Address - Phone:816-554-6003
Mailing Address - Fax:
Practice Address - Street 1:100 NE TUDOR RD STE 110
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5601
Practice Address - Country:US
Practice Address - Phone:816-554-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017017868208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation