Provider Demographics
NPI:1447797766
Name:MCALEAR, JILLIAN (DPT)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:MCALEAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:480 KENOLIO RD APT 7-105
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7531
Mailing Address - Country:US
Mailing Address - Phone:808-975-9590
Mailing Address - Fax:808-207-0351
Practice Address - Street 1:135 S WAKEA AVE STE 112
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1385
Practice Address - Country:US
Practice Address - Phone:808-975-9590
Practice Address - Fax:808-207-0351
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5046225100000X
MA22009225100000X
NV3136225100000X
CO0014541225100000X
HI4261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist