Provider Demographics
NPI:1508070939
Name:WILKINSON, TAWNA C (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:TAWNA
Middle Name:C
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W BOXELDER PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7115
Mailing Address - Country:US
Mailing Address - Phone:480-558-1046
Mailing Address - Fax:
Practice Address - Street 1:520 W BOXELDER PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7115
Practice Address - Country:US
Practice Address - Phone:480-558-1046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist