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Individual
MRS. JENNIFER RENEE FERTIG
Active
Individual
MRS. JENNIFER RENEE FERTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010917L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001632039
HIGHMARK
PA
01
—
081283S6R
MEDICARE
PA
05
—
1015840140001
—
PA
Enumeration date
08/10/2005
Last updated
12/23/2014
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