Search › Pennsylvania › 225100000X
Jaclyn Fantom
NPI 1053296673 · on the registry since 2025
Practice
- Address
- 2410 S Broad St Ste 101
Philadelphia, PA 19145 - Phone
- (215) 334-4400
- Organisation at this address
- Spinal Care Pain Associates, P.C.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-08-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania