Individual
TIMOTHY ALAN WIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3494
(706) 721-3503
Mailing address
1206 GLENWOOD DR, AUGUSTA, GA 30904-3341
(706) 364-1206
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
008955
GA
2251X0800X
Orthopedic Physical Therapist
Primary
008955
GA
Other
Enumeration date
09/10/2008
Last updated
05/19/2011
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