Individual
JESSICA DORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, LAT, ATC
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(260) 266-4007
(260) 266-4008
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
IN
363A00000X
Physician Assistant
Primary
10003918A
IN
Other
Enumeration date
09/08/2016
Last updated
01/29/2026
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