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General NPI Number Information
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NPI Number | 1689892952
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Entity Type | Organization
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Legal Business Name | WILSON PHYSICAL THERAPY. P.A., INC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 1989 S. FEDERAL HIGHWAY SUITE 203
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City | STUART
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State | FL
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Zip | 34994-3949
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Country | US
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Telephone | 772-781-5681
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Fax |
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Provider Business Mailing Address
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Address Line | 1989 S. FEDERAL HIGHWAY SUITE 203
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City | STUART
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State | FL
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Zip | 34994-3949
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Country | US
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Telephone | 772-781-5681
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSIOTHERAPIST
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Name | MR. DWIGHT E WILSON
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Credential |
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Telephone | 772-781-5681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | FLPT0006232
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License Number State | FL
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