Doctor Name: | MR. MICHAEL R WISDOM |
NPI Number: | 1578579686 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT000867 |
Business Practice Address: | 630 Orange St Wisdom Physical Therapy Macon, GA - 31201 |
Business Phone Number: | 4787465469 |
Business Fax Number: | 4787507841 |
Mailing Address: | 630 Orange St, Wisdom Physical Therapy MACON |
State: | GA |
Postal Code: | 31201 |
Phone Number: | 4787465469 |
Fax Number: | 4787507841 |
NPI Enumeration Date: | 07/31/2006 |
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 |