Provider Demographics
NPI:1841441441
Name:SMITH, JILL ALLISON (PT)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:ALLISON
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 CORNFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2478
Mailing Address - Country:US
Mailing Address - Phone:215-752-4535
Mailing Address - Fax:
Practice Address - Street 1:1480 OXFORD VALLEY ROAD
Practice Address - Street 2:MANOR CARE YARDLEY
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-321-3921
Practice Address - Fax:215-321-9257
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001803E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist