Provider Demographics
NPI:1053463307
Name:STONE, JILL (PT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4109 MOUNTAIN VIEW AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-2096
Mailing Address - Country:US
Mailing Address - Phone:423-842-9322
Mailing Address - Fax:866-591-0619
Practice Address - Street 1:9380 BRADMORE LN STE 100
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4435
Practice Address - Country:US
Practice Address - Phone:423-842-9322
Practice Address - Fax:866-591-0619
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2024-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN7967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530340Medicaid
TN271111992013OtherTRI-CARE
TN4169152OtherBCBS OF TENNESSEE
TN891168OtherWELLCARE