Individual
JESSICA DYANN FAMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
611 W BROWN ST STE 101, WYLIE, TX 75098-5816
(972) 442-5287
(972) 442-3181
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 238-8930
(423) 254-5217
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2131626
TX
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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