Individual
JESSICA POLIVKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
252 WATERFORD ST, EDINBORO, PA 16412-2315
(814) 734-8447
Mailing address
252 WATERFORD ST, EDINBORO, PA 16412-2315
(814) 734-8447
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/09/2025
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