Provider Demographics
NPI:1316821325
Name:FONTANA, JILLIAN NICOLE (PT, DPT, NCS, CTRS)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:NICOLE
Last Name:FONTANA
Suffix:
Gender:F
Credentials:PT, DPT, NCS, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1551
Mailing Address - Country:US
Mailing Address - Phone:215-453-3248
Mailing Address - Fax:215-453-3222
Practice Address - Street 1:915 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1551
Practice Address - Country:US
Practice Address - Phone:215-453-3248
Practice Address - Fax:215-453-3222
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022831225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist