Individual
JILLIAN WATSON
Active
Individual
JILLIAN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
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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