Provider Demographics
NPI:1649772989
Name:ALATI, JILLIAN THUM (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:THUM
Last Name:ALATI
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 1:2020 GREENBRIAR CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3244
Mailing Address - Country:US
Mailing Address - Phone:610-209-7529
Mailing Address - Fax:
Practice Address - Street 1:2020 GREENBRIAR CT
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3244
Practice Address - Country:US
Practice Address - Phone:610-209-7529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019932225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist