Provider Demographics
NPI:1538428263
Name:SPENCER BOND, JESSICA PEARL (MA, ATC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:PEARL
Last Name:SPENCER BOND
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 AMY LANE
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201
Mailing Address - Country:US
Mailing Address - Phone:609-602-6294
Mailing Address - Fax:
Practice Address - Street 1:101 VERA KING FARRIS DR
Practice Address - Street 2:OFFICE OF ATHLETICS AND RECREATION, ROOM 309
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9441
Practice Address - Country:US
Practice Address - Phone:609-652-4544
Practice Address - Fax:609-652-4709
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001178002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer