Individual
JILL AMANDA DERUMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T.
Contact information
Practice address
217 K STREET, PINE MOUNTAIN VALLEY, GA 31823-0141
(706) 457-9542
Mailing address
PO BOX 141, PINE MOUNTAIN VALLEY, GA 31823-0141
(706) 457-9542
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006875
GA
Other
Enumeration date
06/08/2010
Last updated
06/26/2012
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