Provider Demographics
NPI:1396084331
Name:CONNER, JESSICA L (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:CONNER
Suffix:
Gender:F
Credentials:DPT
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Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:97 PROGRESS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-9053
Practice Address - Country:US
Practice Address - Phone:717-477-2066
Practice Address - Fax:717-477-2070
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2015-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305207817225100000X
PAPT024711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist