MS. Jennifer Divita, D.O.
NPI #1063646529 in Charleston, West Virginia
Provider Information
- NPI Number
- 1063646529
- Entity Type
- Individual
- Name
- MS. Jennifer Divita, D.O.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pediatrics
- Credential
- D.O.
- Enumeration Date
- May 12, 2009
- Last Updated
- Feb 19, 2013
Practice Location
- Address
- 830 PENNSYLVANIA AVE
- Address 2
- STE 200
- City
- Charleston
- State
- West Virginia
- ZIP Code
- 25302-3302
- Phone
- (304) 388-2709
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Pediatrics |
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