Individual
JILL MAUREEN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
149 LOCUST ST, CONSTANTINE, MI 49042-9601
(574) 536-1679
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004199A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225200000X
PARAGON REHABILITATION
IN
Enumeration date
08/07/2018
Last updated
08/07/2018
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