Provider Demographics
NPI:1699941922
Name:DUBBS, JILL MARIE (PT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:DUBBS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3170
Mailing Address - Country:US
Mailing Address - Phone:440-429-4546
Mailing Address - Fax:216-696-7485
Practice Address - Street 1:1730 W 25TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3170
Practice Address - Country:US
Practice Address - Phone:216-363-2083
Practice Address - Fax:216-696-7485
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004779225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist