Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jordan T Park

Individual provider Physical Therapy Assistant · NPI 1295433191

Jordan T Park is a Physical Therapy Assistant in Lawton, Oklahoma. Works from 2 locations. Licensed in Florida and Georgia.

Licensed in
FL, GA
In the registry since
2023
Specialties on file
2

Practice location Address checks out

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone: (580) 355-8620
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1680 Eatonton Rd, Madison, GA 30650-4628 — (706) 342-1971

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA31577 (FL)
Physical Therapy Assistant Taxonomy 225200000X · Licence PTA004927 (GA)

Record details

NPI number1295433191
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 20, 2023
Last updated in NPPESFebruary 20, 2023
Certification dateFebruary 5, 2023
Mailing address402 Nw Sheridan Rd Apt 1705, Lawton, OK 73505-6573

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