Individual
MRS. JILL K CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
458 W MARKET ST, LONG BEACH, NY 11561-1814
(516) 330-0931
Mailing address
458 W MARKET ST, LONG BEACH, NY 11561-1814
(516) 330-0931
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
021615-1
NY
Other
Enumeration date
11/04/2008
Last updated
09/03/2009
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