Provider Demographics
NPI:1053463307
Name:STONE, JILL (PT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681478
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1478
Mailing Address - Country:US
Mailing Address - Phone:615-591-6590
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:1116 NASHVILLE HWY
Practice Address - Street 2:SUITE 109
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2176
Practice Address - Country:US
Practice Address - Phone:931-840-5116
Practice Address - Fax:931-840-5114
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4169152OtherBCBS OF TENNESSEE
TN4169152OtherBCBS OF TENNESSEE