Provider Demographics
NPI:1720376122
Name:KARGER, JESSE MARIE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:MARIE
Last Name:KARGER
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GRAND PORT RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1520
Mailing Address - Country:US
Mailing Address - Phone:814-558-9744
Mailing Address - Fax:
Practice Address - Street 1:1336 BELMONT AVE
Practice Address - Street 2:SUITE 502B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4500
Practice Address - Country:US
Practice Address - Phone:814-558-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD227456174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist