NPI 1104461367

Jacob Fancher

Practitioner Rehabilitation Counselor Edmonton, KY

Practice location

Address: 112 Sartin Dr, Edmonton, KY 42129-8170
Phone: (270) 901-5000
Fax: (270) 842-5268
Mailing address: 380 Suwannee Trail St, Bowling Green, KY 42103-7956

Registered specialties

Rehabilitation Counselor Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225C00000X

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Registry record

NPI: 1104461367
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Nov 2019
Record last updated: 12 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.