Individual
JACOB R HILLYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
62946
OR
225100000X
Physical Therapist
Primary
PT60855203
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62946
STATE LICENSE
OR
01
—
PT60855203
STATE LICENSE
WA
Enumeration date
08/15/2018
Last updated
08/15/2018
Update your record
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