Individual
MS. JILL MARIE WISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
186 WINDMILL RD, WILLOW GROVE, PA 19090-1638
(215) 582-1456
(215) 659-5120
Mailing address
186 WINDMILL RD, WILLOW GROVE, PA 19090-1638
(215) 582-1456
(215) 659-5120
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC003167L
PA
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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