Provider Demographics
NPI:1033498720
Name:HILL, JEANNA LECLAIRE (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:JEANNA
Middle Name:LECLAIRE
Last Name:HILL
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:JEANNA
Other - Middle Name:
Other - Last Name:LECLAIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:10800 N MILITARY TRL
Mailing Address - Street 2:STE 111
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6527
Mailing Address - Country:US
Mailing Address - Phone:443-977-8190
Mailing Address - Fax:
Practice Address - Street 1:10800 N MILITARY TRL
Practice Address - Street 2:STE 111
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6527
Practice Address - Country:US
Practice Address - Phone:443-977-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist