Provider Demographics
NPI:1619309481
Name:HAMMER, JESSICA KIMBERLIN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:KIMBERLIN
Last Name:HAMMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 INGALLS ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:24422-1864
Mailing Address - Country:US
Mailing Address - Phone:540-816-6607
Mailing Address - Fax:
Practice Address - Street 1:345 POCAHONTAS TRAIL
Practice Address - Street 2:
Practice Address - City:WHITE SULPHER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:24986-0249
Practice Address - Country:US
Practice Address - Phone:304-536-4661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208107225100000X
WV003388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist