MEDICARE: JESSICA C. HILL 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	038787	NY
2	225100000X	Physical Therapist	040-0003547	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DOL605524500	OTHER	VT	OWCP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740241587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA C. HILL PT

Provider Business Mailing Address
First Line	:	9 COOPER BAY S
Second Line	:
City	:	GRAND ISLE
State	:	VT
Zip	:	05458-2430
Country	:	US
Telephone Number	:	802-318-5564
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 COOPER BAY S
Second Line	:
City	:	GRAND ISLE
State	:	VT
Zip	:	05458-2430
Country	:	US
Telephone Number	:	802-318-5564
Fax Number	:	877-659-1695

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	10/28/2020

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