Provider Demographics
NPI:1891995726
Name:LAWLOR, JILLIAN M (ATC, LATC)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:M
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:ATC, LATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4115
Mailing Address - Country:US
Mailing Address - Phone:603-569-7132
Mailing Address - Fax:
Practice Address - Street 1:80 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4115
Practice Address - Country:US
Practice Address - Phone:603-569-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer