Provider Demographics
NPI:1902886617
Name:TROTTER, JILL M (PT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:TROTTER
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 1:4 GREENVILLE ORTHOPEDIC CTR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-1210
Mailing Address - Country:US
Mailing Address - Phone:724-588-9680
Mailing Address - Fax:724-588-9697
Practice Address - Street 1:4 GREENVILLE ORTHOPEDIC CTR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1210
Practice Address - Country:US
Practice Address - Phone:724-588-9680
Practice Address - Fax:724-588-9697
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-006886-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014863980001Medicaid
PA660790OtherHIGHMARK
PA650007010OtherRR MEDICARE
PA650007010OtherRR MEDICARE
PA0014863980001Medicaid