Provider Demographics
NPI:1992084412
Name:HALL, JILLIAN F (DPT)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:F
Last Name:HALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9612
Mailing Address - Country:US
Mailing Address - Phone:413-244-2218
Mailing Address - Fax:
Practice Address - Street 1:54 PINE ST
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9612
Practice Address - Country:US
Practice Address - Phone:413-244-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9178225100000X
MA19587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist