Doctor Name: | JILLAYNE MARIA MAXWELL |
NPI Number: | 1083647895 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 5501004033 |
Business Practice Address: | 14033 Commerce Ave Ne Ste 180 Prior Lake, MN - 553721438 |
Business Phone Number: | 9524405906 |
Business Fax Number: | 9524405907 |
Mailing Address: | 14033 Commerce Ave Ne Ste 180, PRIOR LAKE |
State: | MN |
Postal Code: | 553721438 |
Phone Number: | 9524405906 |
Fax Number: | 9524405907 |
NPI Enumeration Date: | 07/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501004033 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |