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General NPI Number Information
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NPI Number | 1083999569
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Entity Type | Individual
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Provider Name | JILLIAN SARA BLISS DPT
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 90 SWIFTWATER RD
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City | WOODSVILLE
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State | NH
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Zip | 03785-1446
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Country | US
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Telephone | 603-747-9000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2001
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City | WOODSVILLE
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State | NH
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Zip | 03785-2001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4444
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License Number State | NH
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