Organization
JEM PEDIATRIC THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JILL MITCHELL MS, OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(919) 779-9361
Entity
Organization
Contact information
Practice address
113 BENTPINE DR, RALEIGH, NC 27603-5723
(919) 779-9361
Mailing address
113 BENTPINE DR, RALEIGH, NC 27603-5723
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3996
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7301824
—
NC
Enumeration date
07/24/2007
Last updated
07/24/2007
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