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NPI Code Detail

MEDICARE: BRIAN WILKINSON

MEDICARE: BRIAN WILKINSON
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
1225200000XPhysical Therapy Assistant4949AL
2225200000XPhysical Therapy Assistant3205GA

General Provider Information

NPI Number : 1932530359
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN WILKINSON
Provider Business Mailing Address
First Line : 6879 FLATSTONE CT
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-9112
Country : US
Telephone Number : 334-327-8472
Fax Number :
Provider Business Practice Location Address
First Line : 5131 WARM SPRINGS RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-4196
Country : US
Telephone Number : 706-561-1371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2013
Last Update Date : 10/08/2014

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