Provider Demographics
NPI:1336476688
Name:SCHMITZ, JILL K (MPT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:K
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45796 SHAGBARK TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-9294
Mailing Address - Country:US
Mailing Address - Phone:703-444-8642
Mailing Address - Fax:
Practice Address - Street 1:525 E MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4171
Practice Address - Country:US
Practice Address - Phone:703-443-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2305205865225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist