Provider Demographics
NPI:1710567219
Name:HANSON, JILL LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:LYNN
Last Name:HANSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1623
Mailing Address - Country:US
Mailing Address - Phone:317-730-1231
Mailing Address - Fax:
Practice Address - Street 1:5320 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2268
Practice Address - Country:US
Practice Address - Phone:315-469-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist