Healthcare Provider Details

I. General information

NPI: 1013312354
Provider Name (Legal Business Name): JILL SAMPSON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 THE PKWY STE L
GREER SC
29650-5205
US

IV. Provider business mailing address

728 ARNICA DR
DUNCAN SC
29334-8202
US

V. Phone/Fax

Practice location:
  • Phone: 864-210-4164
  • Fax:
Mailing address:
  • Phone: 864-415-2406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15267
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7965
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: