MEDICARE: MRS. JILL HOPE PT

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
1	225100000X	Physical Therapist	11045	OH

General Provider Information

NPI Number	:	1720109671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILL HOPE PT

Provider Business Mailing Address
First Line	:	812 COSHOCTON AVE
Second Line	:	SUITE 4
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1947
Country	:	US
Telephone Number	:	740-392-8811
Fax Number	:	740-392-6485

Provider Business Practice Location Address
First Line	:	812 COSHOCTON AVE
Second Line	:	SUITE 4
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1947
Country	:	US
Telephone Number	:	740-392-8811
Fax Number	:	740-392-6485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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