| Organization Name: | MICHAEL R WISDOM PT PHYSICAL THERAPY INC |
| NPI Number: | 1467466367 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL RAY WISDOM (PRES) |
| Mailing Address: | 630 Orange S Wisdom Physical Therapy Macon |
| State: | GA US |
| Postal Code: | 31201 |
| Phone Number: | 4787465469 |
| Fax Number: | 4787507841 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT000867 |
| 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 |