Provider Demographics
NPI:1578835195
Name:FECHTER, JOANNA M (PT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:M
Last Name:FECHTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 PIMLICO DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2357
Mailing Address - Country:US
Mailing Address - Phone:850-668-0731
Mailing Address - Fax:
Practice Address - Street 1:1818 MICCOSUKEE COMMONS DR
Practice Address - Street 2:SUITE #3
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-6400
Practice Address - Country:US
Practice Address - Phone:850-656-3163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist