Provider Demographics
NPI:1932182482
Name:FORRER, JESSICA M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:M
Last Name:FORRER
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 1:204 SHERANDO CIR
Mailing Address - Street 2:STEPHENS CITY
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-4007
Mailing Address - Country:US
Mailing Address - Phone:540-869-7680
Mailing Address - Fax:
Practice Address - Street 1:1729 N SHENANDOAH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3643
Practice Address - Country:US
Practice Address - Phone:540-636-6179
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist