Provider Demographics
NPI:1245454180
Name:HARRIS, JILL LOUISE (PT)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:LOUISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:LOUISE
Other - Last Name:SELLERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2007 GANYARD RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6021
Mailing Address - Country:US
Mailing Address - Phone:330-836-6882
Mailing Address - Fax:330-836-6882
Practice Address - Street 1:400 COLLIER DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:OH
Practice Address - Zip Code:44230-9757
Practice Address - Country:US
Practice Address - Phone:330-658-5438
Practice Address - Fax:330-658-5437
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 001387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist