Provider Demographics
NPI:1972076198
Name:WINGARD WELLNESS & THERAPY SERVICES
Entity Type:Organization
Organization Name:WINGARD WELLNESS & THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WINGARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS, FDN
Authorized Official - Phone:812-322-1840
Mailing Address - Street 1:8463 S MARCY CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-7208
Mailing Address - Country:US
Mailing Address - Phone:812-322-1840
Mailing Address - Fax:812-316-9897
Practice Address - Street 1:434 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-4603
Practice Address - Country:US
Practice Address - Phone:812-322-1840
Practice Address - Fax:812-316-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty