Daniels, Jill Suzanne

Daniels, Jill Suzanne is an individual health care provider with primary practice located at 4605 Maccorkle Ave Sw , South Charleston WV 25309-1311. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Daniels, Jill Suzanne can be contacted via phone (304) 766-3589.

Contact Information

Primary practice address
4605 Maccorkle Ave Sw South Charleston WV 25309-1311
Phone: (304) 766-3589
Fax: (304) 766-3793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2429 West Virginia

Profile Details

NPI number 1508845595
LBN Legal business name Daniels, Jill Suzanne
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jan 31st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508845595 NPPES
Washington MEDICAID 3810000883

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