Provider Demographics
NPI:1114139664
Name:GILL, JOEI LYNN (MSPE, ATC)
Entity Type:Individual
Prefix:
First Name:JOEI
Middle Name:LYNN
Last Name:GILL
Suffix:
Gender:F
Credentials:MSPE, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 BARRETT RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123-9107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2117 BARRETT RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-9107
Practice Address - Country:US
Practice Address - Phone:937-981-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0008622255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer