Provider Demographics
NPI:1184130940
Name:SEELIG, JILLIAN CAROL (OTR/L)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:CAROL
Last Name:SEELIG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BROWNSTONE RDG
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-3624
Mailing Address - Country:US
Mailing Address - Phone:203-631-0920
Mailing Address - Fax:
Practice Address - Street 1:300 BROWNSTONE RDG
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3624
Practice Address - Country:US
Practice Address - Phone:203-631-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003351208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation