Provider Demographics
NPI:1760461230
Name:INMAN, JILL SUZANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:SUZANNE
Last Name:INMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4206
Mailing Address - Country:US
Mailing Address - Phone:919-776-4289
Mailing Address - Fax:919-774-9421
Practice Address - Street 1:349 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4206
Practice Address - Country:US
Practice Address - Phone:919-776-4289
Practice Address - Fax:919-774-9421
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist