Provider Demographics
NPI:1912082702
Name:CAMPBELL, JILL MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:CAMPBELL
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 1:380 BREVARD RD
Mailing Address - Street 2:ASTON PARK HEALTHCARE CENTER
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2945
Mailing Address - Country:US
Mailing Address - Phone:828-283-0026
Mailing Address - Fax:
Practice Address - Street 1:380 BREVARD RD
Practice Address - Street 2:ASTON PARK HEALTHCARE CENTER
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2945
Practice Address - Country:US
Practice Address - Phone:828-283-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
187220OtherMEDCOST
067XHOtherBCBS
187220OtherMEDCOST