Provider Demographics
NPI:1932584794
Name:HILLER, KIEL WILLIAM (DPT)
Entity Type:Individual
Prefix:MR
First Name:KIEL
Middle Name:WILLIAM
Last Name:HILLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CRESSON AVE
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9722
Mailing Address - Country:US
Mailing Address - Phone:609-287-2155
Mailing Address - Fax:
Practice Address - Street 1:210 S SHORE RD STE 203
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1271
Practice Address - Country:US
Practice Address - Phone:609-390-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01613200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist