NPI 1003602434

Jared R Nikodem, PT

Practitioner Physical Therapist Jacksonville, FL

Practice location

Address: 484 Riverside Ave, Jacksonville, FL 32202-4912
Phone: (904) 579-2824
Mailing address: PO Box 932184, Atlanta, GA 31193-2184

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PT42922 (FL)

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Registry record

NPI: 1003602434
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Apr 2025
Record last updated: 15 Apr 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.