Provider Demographics
NPI:1750483038
Name:WILBANKS, MARGARET M (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:WILBANKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:M
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6397 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-3473
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:590 HISTORIC HIGHWAY 441
Practice Address - Street 2:SUITE E
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535
Practice Address - Country:US
Practice Address - Phone:706-754-6611
Practice Address - Fax:706-754-5834
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT4428225100000X
GAPT004428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA116807Medicare ID - Type UnspecifiedGROUP NUMBER