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NPI Code Detail

MEDICARE: JILLIAN PRINCE PT, DPT

MEDICARE: JILLIAN PRINCE PT, 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 Therapist

General Provider Information

NPI Number : 1659101715
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN PRINCE PT, DPT
Provider Business Mailing Address
First Line : 1719 E FURMAN ST
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-3720
Country : US
Telephone Number : 479-644-0215
Fax Number :
Provider Business Practice Location Address
First Line : 650 S DODSON RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-7015
Country : US
Telephone Number : 479-271-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2024
Last Update Date : 08/05/2024

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Directions to “ JILLIAN PRINCE PT, DPT” Practice Location

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