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Individual

DOROTHY MARYMAY WISDOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT,DPT

Contact information

Practice address
3023 MARINA BAY DR STE 105, LEAGUE CITY, TX 77573-2882
(281) 549-6404
(832) 864-2580
Mailing address
3023 MARINA BAY DR STE 105, LEAGUE CITY, TX 77573-2882
(281) 549-6404
(832) 864-2580

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1071686
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1071686
PHYSICAL THERAPY LISCENSE
TX
Enumeration date
02/13/2020
Last updated
02/13/2020
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