| Doctor Name: | TARA SANSONE WILSON |
| NPI Number: | 1811159106 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT 24102 |
| Business Practice Address: | 11539 Park Woods Cir Suite 502 Alpharetta, GA - 300054413 |
| Business Phone Number: | 6785273224 |
| Business Fax Number: | 6783665886 |
| Mailing Address: | 3575 Old Alabama Rd, ALPHARETTA |
| State: | GA |
| Postal Code: | 300226319 |
| Phone Number: | 5612340431 |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2008 |
| NPI Last Update Date: | 06/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 24102 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| 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 |