Individual
JILL MARIE POLSEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5820 ALLERTON DR, ROCKFORD, IL 61114-6456
(815) 222-6266
Mailing address
5820 ALLERTON DR, ROCKFORD, IL 61114-6456
(815) 222-6266
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004635
IL
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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