Doctor Name: | MICHAEL R WIMBERLY |
NPI Number: | 1700937950 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT,MPT |
License Number: | PT04879 |
Business Practice Address: | 107 Front St Suite 230 Vidalia, LA - 713732836 |
Business Phone Number: | 3183362224 |
Business Fax Number: | 3183366068 |
Mailing Address: | 901 Lindberg Ave, NATCHEZ |
State: | MS |
Postal Code: | 391204884 |
Phone Number: | 6013044161 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT04879 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
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 |