Individual
JASON MEDARD TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
856 N SUPERIOR DR, CROWN POINT, IN 46307-8299
(219) 213-3942
(219) 213-3943
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006915A
IN
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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