Individual
JILL DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1720 VIETH DR, JEFFERSON CITY, MO 65109-2056
(573) 635-6193
Mailing address
2512 SOUTHRIDGE DR APT F, JEFFERSON CITY, MO 65109-2080
(660) 359-7406
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2018037332
MO
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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