Individual
JILL WHATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 CLEARWOOD DR, LONGVIEW, TX 75604-4414
(903) 241-5822
Mailing address
1703 CLEARWOOD DR, LONGVIEW, TX 75604-4414
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
TX
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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