Doctor Name: | MRS. MELISSA GOTTHEIM WILDT |
NPI Number: | 1093751455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OT |
License Number: | 2005000874 |
Business Practice Address: | 2147 Davie Ave Gardens Of Statesville Statesville, NC - 286259200 |
Business Phone Number: | 7048788689 |
Business Fax Number: | |
Mailing Address: | 2222 Sullivan Trl, EASTON |
State: | PA |
Postal Code: | 180407958 |
Phone Number: | 6109912034 |
Fax Number: | 6104382046 |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 06/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2005000874 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |