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NPI Code Detail

MEDICARE: MISS DOLINDA M VAN WIJNEN PT

MEDICARE:  MISS DOLINDA M VAN WIJNEN  PT
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 Therapist4198TN

General Provider Information

NPI Number : 1760435630
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS DOLINDA M VAN WIJNEN PT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 2817 W ANDREW JOHNSON HWY
Second Line :
City : MORRISTOWN
State : TN
Zip : 37814-3216
Country : US
Telephone Number : 423-586-4810
Fax Number : 423-586-4811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 12/14/2018

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Directions to “ MISS DOLINDA M VAN WIJNEN PT” Practice Location

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