Individual
MRS. JENNIFER ETTERS FENDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
218 S MAIN ST, APARTMENT B, NORTH WALES, PA 19454-3410
(215) 616-2412
Mailing address
218 S MAIN ST, APARTMENT B, NORTH WALES, PA 19454-3410
(215) 616-2412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC003930L
PA
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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