Provider Demographics
NPI:1508937038
Name:WILSEY, HEATHER YORK (PT, DPT, NCS)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:YORK
Last Name:WILSEY
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-0037
Mailing Address - Country:US
Mailing Address - Phone:706-754-3113
Mailing Address - Fax:706-754-0088
Practice Address - Street 1:487 N. HISTORIC HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-0037
Practice Address - Country:US
Practice Address - Phone:706-754-3113
Practice Address - Fax:706-754-0088
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist