Doctor Name: | JERI L WISE |
NPI Number: | 1366489668 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | 1045 |
Business Practice Address: | 1701 N Green Valley Pkwy Bldg 8, Ste. B Henderson, NV - 890745885 |
Business Phone Number: | 7029983333 |
Business Fax Number: | |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | 6302962223 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 08/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1045 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
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 |