Provider Demographics
NPI:1811099856
Name:MCELROY, JILLIAN MICHELLE (MS, ATC/L)
Entity type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:MICHELLE
Last Name:MCELROY
Suffix:
Gender:F
Credentials:MS, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 SLAYDEN CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-4334
Mailing Address - Country:US
Mailing Address - Phone:615-513-1384
Mailing Address - Fax:
Practice Address - Street 1:1808 HAYNES ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4547
Practice Address - Country:US
Practice Address - Phone:931-906-4170
Practice Address - Fax:931-906-4173
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAT7402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer