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General NPI Number Information
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NPI Number | 1144228990
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Entity Type | Individual
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Provider Name | JESSICA LYNN KIRCHNER PT
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Gender | Female
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 10201 ARCOS AVE SUITE 204
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City | ESTERO
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State | FL
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Zip | 33928-9459
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Country | US
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Telephone | 239-425-6909
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Fax | 239-992-4589
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Provider Business Mailing Address
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Address Line | 10201 ARCOS AVE SUITE 204
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City | ESTERO
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State | FL
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Zip | 33928-9459
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Country | US
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Telephone | 239-425-6909
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Fax | 239-992-4589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 23271
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License Number State | FL
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