MRS. Jessica Fortner, OTR/L

NPI #1104100130 in Water Valley, Mississippi

Provider Information

NPI Number: 1104100130
Entity Type: Individual
Name: MRS. Jessica Fortner, OTR/L
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: OTR/L
Enumeration Date: Oct 10, 2011
Last Updated: Oct 10, 2011

Practice Location

Address: 194 COUNTY ROAD 371
City: Water Valley
State: Mississippi
ZIP Code: 38965-3998
Phone: (662) 607-0111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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