Healthcare Provider Details

I. General information

NPI: 1285848226
Provider Name (Legal Business Name): JENNIFER BEHREND CO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 06/07/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 HENDERSONVILLE RD
FLETCHER NC
28732-8241
US

IV. Provider business mailing address

3845 HENDERSONVILLE RD
FLETCHER NC
28732-8241
US

V. Phone/Fax

Practice location:
  • Phone: 828-684-1644
  • Fax: 828-684-0648
Mailing address:
  • Phone: 828-684-1644
  • Fax: 828-684-0648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCO006907
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: