Individual
JENNIFER JACQUELYN FAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MSPT, PRPC
Contact information
Practice address
1717 6TH AVE SOUTH, SRC R385, BIRMINGHAM, AL 35249-3329
(205) 975-4922
(205) 934-7420
Mailing address
619 19TH ST S, SRC R385, BIRMINGHAM, AL 35249-7201
(205) 975-4922
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3564
AL
Other
Enumeration date
05/12/2006
Last updated
05/03/2024
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