Provider Demographics
NPI:1134507353
Name:HILLS, JEFFREY (PT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:HILLS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12457 AUTUMNBROOK TRL E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-2365
Mailing Address - Country:US
Mailing Address - Phone:904-762-8169
Mailing Address - Fax:
Practice Address - Street 1:12457 AUTUMNBROOK TRL E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2365
Practice Address - Country:US
Practice Address - Phone:904-762-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist