Provider Demographics
NPI:1942371406
Name:GILL-CHESTNUT, BILLIE RENEE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:BILLIE
Middle Name:RENEE
Last Name:GILL-CHESTNUT
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-4317
Mailing Address - Country:US
Mailing Address - Phone:678-467-9995
Mailing Address - Fax:678-323-8847
Practice Address - Street 1:3609 TRINITY PL
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-4317
Practice Address - Country:US
Practice Address - Phone:678-467-9995
Practice Address - Fax:678-323-8847
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist