Individual
JESSICA FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7402 WESTSHIRE DR STE 105, LANSING, MI 48917-8687
(517) 853-6800
(517) 853-6800
Mailing address
7402 WESTSHIRE DR STE 105, LANSING, MI 48917-8687
(517) 853-6800
(517) 853-6801
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001621
MI
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
08/31/2010
Last updated
01/07/2025
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