Individual
MRS. JILL MARIE LANIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
5639 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1017
(304) 766-0757
(304) 766-0758
Mailing address
5639 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1017
(304) 766-0757
(304) 766-0758
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002224
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302412-000
—
WV
Enumeration date
07/31/2006
Last updated
07/08/2007
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