Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT19105 | FL |
NPI | 1124357017 |
---|---|
Provider Name | Jill A Freedline |
First Address | Royal Palm Beach, FL 33411-4904 |
Second Address | Lantana, FL 33462-6431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2009 |
Last Update Date | 23/12/2009 |