Healthcare Provider Details

I. General information

NPI: 1396721577
Provider Name (Legal Business Name): JILL SYKIER P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 12/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966A PARK ST # A
STOUGHTON MA
02072-3650
US

IV. Provider business mailing address

966A PARK ST # A
STOUGHTON MA
02072-3650
US

V. Phone/Fax

Practice location:
  • Phone: 781-341-2224
  • Fax: 781-341-9328
Mailing address:
  • Phone: 781-341-2224
  • Fax: 781-341-9328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15413
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: