Provider Demographics
NPI:1093197691
Name:HESTER, JESSICA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HESTER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:VALLELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:227 THELMA DR
Mailing Address - Street 2:
Mailing Address - City:BELL BUCKLE
Mailing Address - State:TN
Mailing Address - Zip Code:37020-4874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:227 THELMA DR
Practice Address - Street 2:
Practice Address - City:BELL BUCKLE
Practice Address - State:TN
Practice Address - Zip Code:37020-4874
Practice Address - Country:US
Practice Address - Phone:193-136-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAT00000017922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer