Jill Blaha, MPT
Physical Therapist in De Pere, WI. Individual provider (NPI-1).
NPI number1801912423
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1801912423
- Entity type
- Individual (NPI-1)
- Name
- Jill Blaha
- Credential
- MPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 6518-024 | WI | Yes |
Practice location
1142 Orlando DrDe Pere, WI 54115-9484
Phone 920-339-0700 · Fax 920-330-0278
Mailing address
841 Windsong WayDe Pere, WI 54115
Phone 920-983-6502
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 50 Physical Therapist providers in De Pere · All 764 providers in De Pere
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