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Individual

JILLIAN WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
1503 JOHNSON FERRY RD STE 100, MARIETTA, GA 30062-9112
(770) 415-4815
(470) 253-1386
Mailing address
1503 JOHNSON FERRY RD STE 100, MARIETTA, GA 30062-9112
(770) 415-4815
(470) 253-1386

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2251G0304X
Geriatric Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT015970
GEORGIA STATE BOARD OF PHYSICAL THERAPY
GA
Enumeration date
06/21/2022
Last updated
06/21/2022
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