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General NPI Number Information
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NPI Number | 1609909894
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Entity Type | Individual
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Provider Name | JENNIFER MARIE FOURNIER B.S., PTA
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 50 WOODMONT AVE
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City | LONDONDERRY
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State | NH
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Zip | 03053-3404
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Country | US
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Telephone | 603-699-0097
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Fax |
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Provider Business Mailing Address
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Address Line | 3 PAMELA LN
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City | RAYMOND
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State | NH
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Zip | 03077-1549
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Country | US
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Telephone | 603-895-1290
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1485
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License Number State | NH
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