Doctor Name: | JENNIFER M WISHAM |
NPI Number: | 1285751354 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT008975 |
Business Practice Address: | 665 Gaines School Rd. Athens, GA - 30605 |
Business Phone Number: | 7063698115 |
Business Fax Number: | |
Mailing Address: | 2 Black Oak Ct, CRAWFORD |
State: | GA |
Postal Code: | 306301900 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT008975 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |