Provider Demographics
NPI:1770255523
Name:HENSLEY, JILL LEANN (PT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:LEANN
Last Name:HENSLEY
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 1:741 RIDGEVIEW ESTATES RD
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-7619
Mailing Address - Country:US
Mailing Address - Phone:304-687-1300
Mailing Address - Fax:
Practice Address - Street 1:560 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508-5001
Practice Address - Country:US
Practice Address - Phone:304-310-4721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist