Individual
JILL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
940 S SAINT AUGUSTINE ST, PULASKI, WI 54162-9453
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9625-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36149500
—
WI
Enumeration date
01/02/2008
Last updated
04/10/2025
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