Provider Demographics
NPI:1629261128
Name:BURNS, JILL MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:BURNS
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 1:860 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1316
Mailing Address - Country:US
Mailing Address - Phone:267-542-1295
Mailing Address - Fax:
Practice Address - Street 1:860 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1316
Practice Address - Country:US
Practice Address - Phone:267-542-1295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL-9736225100000X
PAPT019950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist