Doctor Name: | JENNIFER MICHELLE WILSON |
NPI Number: | 1659743458 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT |
License Number: | 60539796 |
Business Practice Address: | 292 Reservation Rd Marina, CA - 939333110 |
Business Phone Number: | 8318838542 |
Business Fax Number: | |
Mailing Address: | 716 Lighthouse Ave, Suite G PACIFIC GROVE |
State: | CA |
Postal Code: | 939502565 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/20/2015 |
NPI Last Update Date: | 10/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 60539796 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
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 |