Healthcare Provider Details

I. General information

NPI: 1124440482
Provider Name (Legal Business Name): JESSICA SCHAFFER MS, ATC, CES, PCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 CLOVERLEAF RD
ELIZABETHTOWN PA
17022-9320
US

IV. Provider business mailing address

24 N JACOB ST
MOUNT JOY PA
17552-1510
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-7675
  • Fax:
Mailing address:
  • Phone: 267-374-7858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT005528
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: