Provider Demographics
NPI:1417400789
Name:WOJTYS, JESSICA C
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:C
Last Name:WOJTYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 PINE TRACE CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7177
Mailing Address - Country:US
Mailing Address - Phone:810-623-5680
Mailing Address - Fax:
Practice Address - Street 1:5932 PINE TRACE CT
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7177
Practice Address - Country:US
Practice Address - Phone:810-623-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other