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1891934980
JESSICA L FORTWENGLER
CRESTWOOD, KY
NPI
1891934980
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: KY 42398)
Enumeration Date
2009-02-12
Last Update Date
2015-01-17
Business Address
-- JESSICA L FORTWENGLER MD
6580 KENWOOD CROSSING ROAD
CRESTWOOD, KY 40014
Phone number: 502-243-3161
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Mailing Address
-- JESSICA L FORTWENGLER MD
PO BOX 950248
LOUISVILLE, KY 40295-0248
Phone number: 502-489-5730
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