| NPI | 1598001216 |
|---|---|
| Former Name | JILLIAN BLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 20321) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035711) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2019-07-02 |