Provider Demographics
NPI:1497116594
Name:FEHR, JESSE (MS, LAT, ATC)
Entity Type:Individual
Prefix:MS
First Name:JESSE
Middle Name:
Last Name:FEHR
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 N HIGH ST
Mailing Address - Street 2:APT 2N
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2495
Mailing Address - Country:US
Mailing Address - Phone:267-221-6471
Mailing Address - Fax:
Practice Address - Street 1:418 N HIGH ST
Practice Address - Street 2:APT 2N
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2495
Practice Address - Country:US
Practice Address - Phone:267-221-6471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTO0001302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer