Kevin Wisdom P.T.

NPI 1063485670 - Physical Therapist - 225100000X

NPI Details
NPI 1063485670
Gender Male
Enumeration Date 02/13/2006
Last Updated 12/14/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
3317 N WIMBERLY DR
FAYETTEVILLE AR, 72703-4056, US
Phone (479) 521-2752
Fax (479) 444-6942
Business Location
PO BOX 1608
FAYETTEVILLE AR, 72702-1608, US
Phone (479) 521-2752
Fax (479) 444-6942
Toxanomy
Taxonomy Code 225100000X
License State Arkansas
License Number PT2490
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According to our database, Kevin Wisdom P.T. NPI is 1063485670, taxonomy code is 225100000X and license number is PT2490, license state is located at Arkansas. Kevin Wisdom P.T. physically located at 3317 N Wimberly Dr, Fayetteville AR, 72703-4056. NPI Number Kevin Wisdom P.T. has the Individual type.

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1063485670 NPI number is provided on an as is basis without warranty of any kind. 1063485670 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin Wisdom P.T. are for informational purposes only.