MEDICARE: JOHN W HILSON

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	PT000792E	PA

General Provider Information

NPI Number	:	1982624680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN W HILSON

Provider Business Mailing Address
First Line	:	638 ALDEN ST
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2348
Country	:	US
Telephone Number	:	814-337-9535
Fax Number	:

Provider Business Practice Location Address
First Line	:	638 ALDEN ST
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2348
Country	:	US
Telephone Number	:	814-337-9535
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/18/2008

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