Provider Demographics
NPI:1598819062
Name:MORE, JESUS ILIN JR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JESUS
Middle Name:ILIN
Last Name:MORE
Suffix:JR
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HIGHLAND CIR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6626
Mailing Address - Country:US
Mailing Address - Phone:609-927-2464
Mailing Address - Fax:
Practice Address - Street 1:26 HIGHLAND CIR
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6626
Practice Address - Country:US
Practice Address - Phone:609-927-2464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA00863700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist