Provider Demographics
NPI:1437373453
Name:MCGILL, JOANNA (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:MCGILL
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 1:153 SOUTHWIND WAY
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9188
Mailing Address - Country:US
Mailing Address - Phone:317-435-5297
Mailing Address - Fax:317-865-1393
Practice Address - Street 1:153 SOUTHWIND WAY
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9188
Practice Address - Country:US
Practice Address - Phone:317-435-5297
Practice Address - Fax:317-865-1393
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006308A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics