Individual
AILEEN IBANEZ-WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
840 PINE ST STE 880, MACON, GA 31201-7525
(478) 743-7092
(478) 743-6293
Mailing address
849 PARKVIEW DR, MACON, GA 31211-1422
(478) 718-8547
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
007662
GA
Other
Enumeration date
05/20/2008
Last updated
10/21/2025
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