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NPI Code Detail

MEDICARE: JILL MICHELLE HENDERZAHS-MASON DPT

MEDICARE:   JILL MICHELLE HENDERZAHS-MASON  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist9253MN
2225100000XPhysical Therapist05015292AIN

General Provider Information

NPI Number : 1467412809
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL MICHELLE HENDERZAHS-MASON DPT
Provider Business Mailing Address
First Line : PO BOX 781076
Second Line :
City : DETROIT
State : MI
Zip : 48278-1076
Country : US
Telephone Number : 317-528-4800
Fax Number : 317-865-1479
Provider Business Practice Location Address
First Line : 426 S ALABAMA ST STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46225-3301
Country : US
Telephone Number : 317-528-6804
Fax Number : 317-528-3781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 06/19/2025

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Directions to “ JILL MICHELLE HENDERZAHS-MASON DPT” Practice Location

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