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Individual

MRS. ALLISON H WIRT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
300B TEMPLE LAKE DR, SUITE 1, COLONIAL HEIGHTS, VA 23834-2973
(804) 524-9036
(804) 524-9039
Mailing address
771 PILOT HOUSE DR, NEWPORT NEWS, VA 23606-1990
(757) 873-2302
(757) 873-2306

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202840
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010306060
VA
01
192946
BCBS (PHYS. THERAPY)
VA
01
7058866
AETNA
VA
01
P00395286
RAILROAD MEDICARE
VA
Enumeration date
01/10/2007
Last updated
04/22/2008
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