Individual
JESSICA HARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1000 SYIANNA WAY, FORT SMITH, AR 72919-0001
(920) 261-1128
Mailing address
813 DEMPSTER ST, FORT ATKINSON, WI 53538-1621
(920) 723-7306
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2818-19
WI
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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