Individual
JILL LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3325 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 774-2400
Mailing address
3325 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 774-2400
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
6535
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5907250
—
NC
Enumeration date
07/20/2007
Last updated
11/15/2007
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