Individual
JILL GHOLSON-HEARNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, PES
Contact information
Practice address
2775 VILLAGE PT, CHESTERTON, IN 46304-0099
(219) 304-6700
Mailing address
6304 MARIETTA AVE, PORTAGE, IN 46368-5158
(219) 545-8951
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003488A
IN
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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