Provider Demographics
NPI:1063937548
Name:HILTON, ISIS FAITH (PTA)
Entity type:Individual
Prefix:
First Name:ISIS
Middle Name:FAITH
Last Name:HILTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 SALT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OK
Mailing Address - Zip Code:73448-7340
Mailing Address - Country:US
Mailing Address - Phone:580-812-1788
Mailing Address - Fax:
Practice Address - Street 1:1907 REFINERY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2111
Practice Address - Country:US
Practice Address - Phone:210-724-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2133586225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant