Healthcare Provider Details

I. General information

NPI: 1689799785
Provider Name (Legal Business Name): GAIL E HILL PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GAIL E EMRICH PTA

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 BROAD ST
WEYMOUTH MA
02188-2336
US

IV. Provider business mailing address

28 JERROLD ST
HANSON MA
02341-1306
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-3121
  • Fax:
Mailing address:
  • Phone: 781-293-5250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3942
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: