Healthcare Provider Details

I. General information

NPI: 1548594906
Provider Name (Legal Business Name): GRETCHEN HILL PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 RIVER RD
WILMINGTON DE
19809-2704
US

IV. Provider business mailing address

1306 SAVILLE AVE
EDDYSTONE PA
19022-1305
US

V. Phone/Fax

Practice location:
  • Phone: 302-764-7000
  • Fax:
Mailing address:
  • Phone: 610-715-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberJ2-0000508
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: