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Individual

JILL MARIE HERREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
100 NETHERLAND LN, KINGSPORT, TN 37660-7245
(423) 245-0360
Mailing address
2024 CANTERBURY RD, KINGSPORT, TN 37660-5027
(423) 276-5258

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1792
TN

Other

Enumeration date
01/14/2019
Last updated
01/14/2019
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