| Doctor Name: | MR. STEPHEN BRUCE WILMOT |
| NPI Number: | 1558416107 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT009355 |
| License Number: | PT009355 |
| Business Practice Address: | 5740 Windmill Way Suite 15 Carmichael, CA - 956081379 |
| Business Phone Number: | 9164827698 |
| Business Fax Number: | 9164827798 |
| Mailing Address: | 5905 Murray Pl, FAIR OAKS |
| State: | CA |
| Postal Code: | 956282510 |
| Phone Number: | 9169672308 |
| Fax Number: | 9164827798 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | PT009355 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |