Individual
JEANNIE PHEARSDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
515 MAIN ST, OLEAN, NY 14760-1513
(716) 373-2600
Mailing address
2515 N NINE MILE RD, ALLEGANY, NY 14706-9767
(716) 373-4060
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005885-1
NY
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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