Organization
PELVIC WISDOM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMILY KATHERINE WILSON DPT (PHYSICAL THERAPIST)
(973) 885-1661
Entity
Organization
Contact information
Practice address
222 AUBURN ST STE 103, PORTLAND, ME 04103-6005
(207) 200-6293
Mailing address
222 AUBURN ST STE 103, PORTLAND, ME 04103-6005
(207) 200-6293
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962860585
—
WY
Enumeration date
03/23/2021
Last updated
03/23/2021
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