Provider Demographics
NPI:1649333527
Name:GILL, JERI ANN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:JERI
Middle Name:ANN
Last Name:GILL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Mailing Address - Street 1:2 W MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-6505
Mailing Address - Country:US
Mailing Address - Phone:580-223-3383
Mailing Address - Fax:580-223-6696
Practice Address - Street 1:2 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6505
Practice Address - Country:US
Practice Address - Phone:580-223-3383
Practice Address - Fax:580-223-6696
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2242225100000X
TX1116960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist