Provider Demographics
NPI:1124311527
Name:CROPPER, JILL
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:CROPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5788 CAMP RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121
Mailing Address - Country:US
Mailing Address - Phone:937-213-6653
Mailing Address - Fax:
Practice Address - Street 1:5788 CAMP RUN RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-9434
Practice Address - Country:US
Practice Address - Phone:937-213-6653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07544261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy