Provider Demographics
NPI:1770528556
Name:HEGY, JILL JULIETT (MPT, DPT)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:JULIETT
Last Name:HEGY
Suffix:
Gender:F
Credentials:MPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801
Mailing Address - Country:US
Mailing Address - Phone:307-675-2327
Mailing Address - Fax:866-645-0523
Practice Address - Street 1:38 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801
Practice Address - Country:US
Practice Address - Phone:307-675-2327
Practice Address - Fax:866-645-0523
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1151PT225100000X
WYPT-1168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist