Provider Demographics
NPI:1811028392
Name:GINIGER, JILL (LMT)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:
Last Name:GINIGER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5924 THOMAS DRIVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32408-5612
Mailing Address - Country:US
Mailing Address - Phone:850-234-6563
Mailing Address - Fax:850-235-6955
Practice Address - Street 1:5924 THOMAS DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32408-5612
Practice Address - Country:US
Practice Address - Phone:850-234-6563
Practice Address - Fax:850-235-6955
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31491174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA31491OtherLICENSED MASSAGE THERAPIS