Individual
JESSICA JETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3147 NW 69TH CT, FORT LAUDERDALE, FL 33309-1236
(954) 495-6085
Mailing address
3147 NW 69TH CT, FORT LAUDERDALE, FL 33309-1236
(954) 495-6085
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FLORIDA
—
FL
Enumeration date
09/04/2016
Last updated
09/04/2016
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