Provider Demographics
NPI:1568861060
Name:PFROMMER, JESSICA INTHAVONGXAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:INTHAVONGXAY
Last Name:PFROMMER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:621 E JUBAL EARLY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-5178
Mailing Address - Country:US
Mailing Address - Phone:540-667-0130
Mailing Address - Fax:
Practice Address - Street 1:621 E JUBAL EARLY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5178
Practice Address - Country:US
Practice Address - Phone:540-667-0130
Practice Address - Fax:540-667-3893
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006582213ES0103X
VA0103301203213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery