Provider Demographics
NPI:1124391396
Name:GALANTER, JILL RENEE (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:RENEE
Last Name:GALANTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N 2ND ST
Mailing Address - Street 2:STE 201
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6077
Mailing Address - Country:US
Mailing Address - Phone:208-489-4999
Mailing Address - Fax:208-489-4075
Practice Address - Street 1:510 N 2ND ST
Practice Address - Street 2:STE 201
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6077
Practice Address - Country:US
Practice Address - Phone:208-489-4999
Practice Address - Fax:208-489-4075
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist