Provider Demographics
NPI:1720657802
Name:JORDAN, SHON D'ANN (DPT, OCS)
Entity type:Individual
Prefix:
First Name:SHON
Middle Name:D'ANN
Last Name:JORDAN
Suffix:
Gender:F
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 S WADSWORTH BLVD STE A-2
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5026
Mailing Address - Country:US
Mailing Address - Phone:303-993-4438
Mailing Address - Fax:303-993-4817
Practice Address - Street 1:3255 S WADSWORTH BLVD STE A-2
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5026
Practice Address - Country:US
Practice Address - Phone:303-993-4438
Practice Address - Fax:303-993-4817
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16193225100000X
COCP042526T2251X0800X
CO207082251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist