Individual
JACQUELYN ANN FETCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
212 IRIS RD, SEWICKLEY, PA 15143-2402
(412) 741-2375
Mailing address
500 MARKET ST, SUITE 103, BEAVER, PA 15009-2998
(724) 586-5123
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC005362L
PA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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