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Individual

JILL ALLISON FAGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
201 GLENWICK PL, ALLEN, TX 75013-1528
(972) 489-9260
Mailing address
201 GLENWICK PL, ALLEN, TX 75013-1528
(972) 489-9260

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2037240
TX

Other

Enumeration date
11/19/2012
Last updated
04/13/2015
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