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NPI Code Detail

MEDICARE: ZACHARY DAVID WISKOW

MEDICARE: ZACHARY DAVID WISKOW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP24066NC

General Provider Information

NPI Number : 1013709591
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY DAVID WISKOW
Provider Business Mailing Address
First Line : PO BOX 5105
Second Line :
City : BELFAST
State : ME
Zip : 04915-5100
Country : US
Telephone Number : 919-220-5255
Fax Number : 919-220-6971
Provider Business Practice Location Address
First Line : 6019 OLEANDER DR STE 200
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-4813
Country : US
Telephone Number : 919-790-9714
Fax Number : 910-791-1063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2025
Last Update Date : 12/16/2025

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Directions to “ ZACHARY DAVID WISKOW ” Practice Location

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