JACLYN FANTOM

PHILADELPHIA, PA
NPI1053296673
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: PA  PT033564)
Enumeration Date2025-08-11
Last Update Date2025-08-13
Business Address
JACLYN FANTOM
2410 S BROAD ST STE 101
PHILADELPHIA, PA 19145-4418
Phone number: 215-334-4400
Mailing Address
JACLYN FANTOM
2734 S 11TH ST
PHILADELPHIA, PA 19148-4902
Phone number: 267-684-9027
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