Individual
MICHAEL R WIMBERLY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,MPT
Contact information
Practice address
107 FRONT ST STE 230, VIDALIA, LA 71373-2836
(318) 336-2224
(318) 336-6068
Mailing address
901 LINDBERG AVE, NATCHEZ, MS 39120-4884
(601) 304-4161
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT04879
LA
225100000X
Physical Therapist
PT3657
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04220001
—
MS
05
—
2318781
—
LA
Enumeration date
01/15/2007
Last updated
10/08/2025
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