Provider Demographics
NPI:1013312354
Name:SAMPSON, JILL (DPT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SAMPSON
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 ARNICA DR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8202
Mailing Address - Country:US
Mailing Address - Phone:864-415-2406
Mailing Address - Fax:
Practice Address - Street 1:528 HOWELL RD STE 14
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2050
Practice Address - Country:US
Practice Address - Phone:864-210-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15267225100000X
SC7965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist