Provider Demographics
NPI:1922065804
Name:WILKINSON, ANN (PT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BULLOCK RD
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-1558
Mailing Address - Country:US
Mailing Address - Phone:610-255-5508
Mailing Address - Fax:
Practice Address - Street 1:17 BULLOCK RD
Practice Address - Street 2:
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-1558
Practice Address - Country:US
Practice Address - Phone:610-255-5508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001049E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232523YF8BMedicare PIN
DEHOH966Medicare PIN