Provider Demographics
NPI:1376563544
Name:ORWICK, JESSICA LOREENE (AT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LOREENE
Last Name:ORWICK
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2969 CARLSBAD DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8877
Mailing Address - Country:US
Mailing Address - Phone:614-795-6752
Mailing Address - Fax:
Practice Address - Street 1:2969 CARLSBAD DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8877
Practice Address - Country:US
Practice Address - Phone:614-795-6752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT. 0025422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer