Provider Demographics
NPI:1740239144
Name:SCHOFIELD, JILLIAN P (DPT)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:P
Last Name:SCHOFIELD
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 1:3320 EXECUTIVE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7445
Mailing Address - Country:US
Mailing Address - Phone:919-872-3747
Mailing Address - Fax:919-872-3414
Practice Address - Street 1:3320 EXECUTIVE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7445
Practice Address - Country:US
Practice Address - Phone:919-872-3747
Practice Address - Fax:919-872-3414
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8308225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7212664Medicaid
NC2507770Medicare ID - Type Unspecified