Individual
MRS. JESSICA FORTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
194 COUNTY ROAD 371, WATER VALLEY, MS 38965-3998
(662) 607-0111
Mailing address
194 COUNTY ROAD 371, WATER VALLEY, MS 38965-3998
(662) 607-0111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT2111
MS
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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