MEDICARE: MR. GORDON WAI LEONG WOON 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
1	225100000X	Physical Therapist	P20776	NC

General Provider Information

NPI Number	:	1952428542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GORDON WAI LEONG WOON PT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	510-529-6460
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 MARKET ST STE 120
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-9888
Country	:	US
Telephone Number	:	910-686-1604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/02/2025

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